The current wave of Omicron variant Covid-19 infections will be a challenge for health care systems to deal with. But once it's over, cases should drop and life may regain some semblance of normalcy, at least for the rest of 2022.

That prediction came from Bill Gates during a Twitter Q&A this week with Devi Sridhar, professor of global public health at the University of Edinburgh Medical School. Sridhar asked Gates the question that's on everyone's mind: "How and when will the pandemic be over?"

"As countries experience their Omicron wave, health systems will be challenged," he answered. "Most of the severe cases will be unvaccinated people. Once Omicron goes through a country, then the rest of the year should see far fewer cases, so Covid can be treated more like a seasonal flu." In other words, Covid could transition from its current pandemic state to an endemic state in which the disease is still around, and remains dangerous, especially to the most vulnerable, but enough people have enough immunity that it no longer disrupts our daily lives. Several past pandemics have made this transition to endemic status, including the 1918 influenza and the swine flu pandemic of 2009. 

It should be emphasized that in the United States, we are still very much in the grip of the Omicron wave. The day before Gates's Q&A, the United States hit a new high of 1.35 million new cases in a single day. Infections are four times higher than they were at last winter's peak, with hospitalizations at an all-time high as well.

Once the current wave is over, though, we may get some respite from Covid for the balance of the year. "A more transmissive variant is not likely but we have been surprised a lot during this pandemic," Gates tweeted. "Omicron will create a lot of immunity at least for the next year." But, he added, "We may have to take yearly shots for Covid for some time."

Subject to misinformation

Sridhar also asked Gates about the challenges of fighting the pandemic when misinformation has spread so rapidly on social media. "Social media got behind on trying to get factual information out--there will be a lot of debate about how to do better on that," Gates said. "People like you and I and Tony Fauci have been subject to a lot of misinformation. I didn't expect that. Some of it, like me putting chips in arms, doesn't make sense to me--why would I want to do that?" ("I'd make a joke but would cause a storm," Sridhar responded with a laughing emoji.)

Sridhar also tackled what might be the most important question of all--how prepared are we for the next pandemic? This time around, Gates said, only a few countries acted swiftly to put social distancing measures in place and isolate the infected. Those that did were able to "limit the number of deaths dramatically," he added. "Once the numbers get large in a country, it is too late."

To deal more effectively with the next pandemic, world leaders will need to prepare ahead of time, Gates noted. And there are some signs that may happen. For example, Gates noted, WHO director-general Tedros Adhanom Ghebreyesus has already begun an important conversation about how to prepare for the next pandemic. He also praised Sridhar, saying he appreciated her work in this area. "We can do a lot better next time!!" he tweeted. Let's hope he's right.