The acute phase of the Covid-19 pandemic will come to an end in 2022. Bill Gates made that prediction in his end-of-the-year blog post for 2021. Gates, like most of us, was hoping to see more progress against the pandemic in 2021 than actually happened. Instead, he noted, more people died of Covid in 2021 than in 2020.
But, he wrote, more normal times may finally be within sight. Here are four reasons he's optimistic about the pandemic--and one thing that worries him a lot.
1. We've learned a lot about how to deal with variants.
"There's no question that the Omicron variant is concerning," Gates wrote. Like many in the science community, he stressed that we need to learn more about this new variant and said that researchers should have some answers very soon. "But here's what we do know: The world is better prepared to tackle potentially bad variants than at any other point in the pandemic so far," he wrote.
Because South Africa has made genomic sequencing a priority, we discovered the Omicron variant much more quickly than the Delta variant. He added, "We're in a much better position to create updated vaccines if they're needed."
2. We've gotten really good at vaccines.
MRNA (or messenger RNA) vaccines may someday be seen as the most important breakthrough of the pandemic, Gates wrote. "Proving that mRNA works as a vaccine platform has been a massive game-changer--not just for this pandemic, but for the next one, too," he said.
MRNA vaccines are different from traditional vaccines in which a weakened or inert form of the infection is introduced into the body so that the body's immune system can learn to deal with it. MRNA vaccines only carry messenger RNA created in a lab to introduce the spike protein (which the virus carries) into our cells, triggering the same sort of immune response as a traditional vaccine. Rather than getting a weakened form of the virus, you get no virus at all, making mRNA safer than traditional vaccines. It can be produced more quickly as well. "Now that mRNA is well-established, we'll be able to develop safe and effective vaccines super fast in the future," Gates wrote.
3. We're developing better treatments.
While vaccines that prevent people from getting very ill with Covid have been an amazing success story, the same can't be said for treatments once someone has the disease, Gates wrote. The treatments developed up till now do help somewhat, but they're not as effective as he had hoped, and they aren't easy enough to distribute.
Two new antiviral drugs may be about to change that, Gates wrote. One of them, molnupiravir, manufactured by Merck, recently won FDA approval for use in high-risk people. It can significantly reduce your chances of being hospitalized or dying if you catch Covid, and it's relatively cheap to make and easy to distribute, he wrote. "I just wish it had come along sooner," he said.
4. We've learned a lot about mandates.
Governments and businesses have learned a lot about non-pharmaceutical interventions (NPIs), which include things like mask mandates, lockdowns, and travel bans, Gates wrote. "Next time, the world will be ready to deploy cheap and easy tools like masks much quicker, and governments will have a greater understanding of when and how to deploy more burdensome strategies like lockdowns," he said.
5. But people don't trust their governments.
If there's one thing that truly worries Gates, particularly when it comes to the pandemic, it's the deep distrust of governments and other institutions that has only grown this past year. "I thought demand for vaccines would be way higher than it has been in places like the United States," he wrote. "It's clear that disinformation (including conspiracy theories that unfortunately involve me) is having a substantial impact on people's willingness to get vaccinated."
This is part of what he considers a very worrisome trend toward people distrusting their governments. "This era has shown us how declining trust in public institutions is creating tangible problems and complicating our efforts to respond to challenges," he wrote. When a crisis such as a pandemic arises, people are less likely to follow the guidance needed to get through it.
One big part of the problem, he noted, is social media that helps amplify misinformation in very unhelpful ways. "A video falsely claiming that the Covid-19 vaccine makes you infertile should not be allowed to spread widely under the guise of being news," he wrote. Gates added that he would usually follow a statement such as this one with his ideas about how to fix the problem--but this time he doesn't have any clear answers.
It's striking that Gates, who has willingly tackled poverty, deadly diseases, nuclear power, and climate change, considers this issue of distrust too difficult for him to solve. Instead, he wrote, he'll keep reading and keep seeking ideas from other people, hoping that someone--perhaps someone younger than he is--will have some ideas that might help. All the rest of us can do is hope so too.