He's also baffled by an utterly false and bizarre conspiracy theory.
Microsoft co-founder Bill Gates answered a variety of questions about the coronavirus on Twitter on Tuesday, and his answers might point to a slightly easier 2022 for a world that's weary of battling with surge after surge. Devi Sridhar, director of Global Health Governance and professor at the University of Edinburgh Medical School in Scotland, invited Twitter users to send her questions to ask Gates.
Gates himself isn't a scientist or a physician, and to be clear, in the Twitter thread, he was sharing his opinions. But it's a topic he knows well. As the co-founder of the Bill & Melinda Gates Foundation, he has spent billions to bring vaccines to the developing world, well before the coronavirus pandemic.
Sridhar's final question may have been the one most people wanted to ask.
"How and when will the pandemic be over?" she asked. "Does omicron show that we can 'live with COVID'? Or are other dangerous variants around the corner in 2022?"
Gates noted the grim effects of the omicron variant, especially on the unvaccinated.
"As countries experience their omicron wave health systems will be challenged. Most of the severe cases will be unvaccinated people," he wrote. But there's hope.
"Once omicron goes through a country then the rest of the year should see far fewer cases so COVID can be treated more like seasonal flu," Gates said.
And is there an even more-contagious variant lurking somewhere after omicron? Gates doesn't think so, but isn't ready to bet the farm on it.
"A more transmissive variant is not likely but we have been surprised a lot during this pandemic," he wrote. "Omicron will create a lot of immunity at least for the next year. (Trevor Bedford, a scientist at Seattle's Fred Hutchinson Cancer Research Center) tracks the genetics really well. We may have to take yearly shots for COVID for some time."
And where did the COVID-19 virus come from? That's a hotly debated topic. A 2021 World Health Organization study offers no definitive answers, though it reiterates that a leak from a Chinese laboratory is "extremely unlikely" and that the virus most likely jumped from animals to humans.
"The data is pretty strong that it came from another species which is true for most pandemics," Gates said. "People will continue to speculate on this and we should make sure labs are careful. There will be future outbreaks coming from other species so we need to invest in being ready."
Sridhar also asked Gates about the conspiracy theories and misinformation about the pandemic. He's been at the heart of plenty of false coronavirus rumors. Even his oldest daughter, Jennifer, has joked about them.
Gates said groups such as the World Health Organization and Centers for Disease Control and Prevention need more resources to get on top of pandemics early and spread correct information, and that social media fell behind as far as sharing the truth. And he expressed bewilderment at one of the more bizarre conspiracy theories.
"People like you and I and Tony Fauci have been subject to a lot of misinformation," he wrote. "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?"
Gates also said that the biggest scientific breakthrough that would help end the pandemic would be better and longer-lasting vaccines.
"The vaccines we have prevent severe disease and death very well but they are missing two key things," he said. "First they still allow infections ('breakthrough') and the duration appears to be limited. We need vaccines that prevent re-infection and have many years of duration."
He also praised countries that moved quickly to deal with the pandemic.
"A few countries like Australia moved fast to diagnose cases at scale and isolate people who were infected," Gates said. "They were able to limit deaths dramatically. Once the numbers get large in a country it is too late. So the first few months made a lot of difference."
In December, Gates said that 2021 was the hardest year of his life, and noted that he canceled his own holiday plans after close friends came down with COVID-19. But even then, he was optimistic that the omicron wave could burn itself out in three months.
"I still believe if we take the right steps, the pandemic can be over in 2022," Gates said then.