University of Melbourne Vice-Chancellor Duncan Maskell
© Justin McManusUniversity of Melbourne Vice-Chancellor Duncan Maskell
"Every answer to that question is valid in one way or another. If you were to say we have no appetite whatsoever for any deaths from this virus, that is a perfectly reasonable position to take, but you have to take that position knowing the consequences.

"If that decision stops people dying now from the virus, what are the economic consequences of that for people and how will that play out in terms of future mortality? It would be crazy if, hypothetically, we stop 100 people [dying] from the virus but over the next two years, 200 people died from [the effects of] poverty and mental health."

Professor Maskell says decision-makers must consider the role of quality-adjusted life year (QALY), a unit of measurement used by economists to predict and assess the impact of health policies. In simple terms, it assumes that a life near its end, whether because of disease or advanced age, is empirically different to a healthy life closer to its beginning.

"We have to look at this as an overall picture. My personal view is there should be some form of sensible, public health, QALY-based analysis done and tough calls made. It boils down to a basic but very hard moral philosophy: What is the value of a 90-year-old's life versus the value of the continuing livelihood and happiness of a 25-year-old?'' he said.


Professor Maskell arrived in Melbourne at the end of 2018 from the University of Cambridge to take over the running of Australia's top-ranked university. He spoke to The Sunday Age as part of a series of stories in which prominent Melburnians offer constructive ideas about Victoria's way forward.

Each day throughout the pandemic, Premier Daniel Andrews has detailed COVID deaths recorded in the previous 24 hours, routinely describing as "tragic'' the deaths of people in their 80s and 90s, including some who were in palliative care before they were infected.

The Victorian government's response to our second wave epidemic - broad suspension of commercial, educational and social activity to reduce the spread of the virus - stands in contrast to the approach being taken by European nations such as France, the UK, the Netherlands and Austria, where governments are resisting a return to lockdown despite facing substantially higher COVID case loads, and deaths, than we are.

As French President Emmanuel Macron said last week:
"We must adapt to the evolution of the virus, slow down its circulation as much as possible. But we must do it by allowing us to continue living: educating our children, taking care of other patients, treating other health matters, and having an economic and social life.''

Comment: Common sense from Macron. Who knew?


Why has Victoria taken such a different approach? Professor Maskell wonders whether we are a victim of our early success.

"Australia dealt with it so efficiently at the start of the pandemic it became possible in people's minds to eliminate the virus or keep it down at very low levels. If you look at Western Australia and South Australia and the Northern Territory, people would argue why can't Victoria and NSW do that?

"In other countries, either because they decided to do this, as in Sweden, or they were a shambles, as in the UK, they have got used to this virus being around and people dying from it. There is an experiential thing there, not just a national characteristic.

"What people need to keep front and centre is the only certainty in life is death. The only event in our life with a probability of one is you are going to die. You can't protect all lives all the time without consequences. That is the very tricky and difficult discussion that needs to be had.

"Personally, I think it is an absolute tragedy that young people's lives are being disrupted. But it is a tragedy for everyone around the world that this virus has come along.''

What the pandemic means for the University of Melbourne remains unclear. Professor Maskell is presently dealing with two thorny issues: preparing for a likely, abrupt downturn in international students next year and working through what this means for revenue, research and staff levels.

He laments what the absence of international students will mean, beyond the bottom line, for the university's culture. "Universities have always been international organisations, right back to medieval times. It is a great strength of universities that you have international students and workers in the organisation who bring their perspective and a different view on the world.''

Professor Maskell came to Melbourne after a career that included senior positions in teaching, research, administration and advising government on health policy. He was only in the job for a year when the first COVID-19 case was confirmed.

In 2019, international students comprised 44 per cent of the University of Melbourne's student body and contributed 59 percent of student revenue. Professor Maskell says the pandemic will force significant, lasting change to how the university operates.

"We will do more of our knowledge delivery online but I think that will free up space and time for doing more important things,'' he says. "Universities aren't there just to plough knowledge into people's heads; they are there to light the fire, to start people thinking anew about things and become people who are interested in investigating subjects deeper.

"We have got to reimagine what our campuses are for. I am very clear in my mind that it won't be a university experience at all, in terms of giving young people the opportunity to grow up and understand the world and people around them, if they can't be on campus for a big chunk of that time. But they won't be sitting in big lecture theatres getting bored listening to someone like me drone on at the front.''