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4 Big COVID Predictions for 2024

As the pandemic enters its fifth year, here’s what experts expect to change — and what to stay the same

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It’s been about four years since COVID-19 was first identified, and in that time, much has changed, including the virus itself. We now have pills that can treat it and at-home tests that can identify an infection. We also have vaccines that have been updated to better match versions of the virus that are currently circulating.

Despite these achievements, COVID-19 is still with us — and will be for some time, health experts say. Here’s what we can expect as we head into our fifth year with COVID-19.

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1. COVID probably won’t settle into a predictable pattern

The cold-weather months are synonymous with respiratory viruses. But unlike flu and RSV — where activity picks up in the fall and winter and peters off in the spring and summer — COVID-19 doesn’t have a set season. Waves hit in the winter, spring, summer and fall.

While COVID could settle into a more predictable pattern in the future, that likely won’t happen in 2024, says Robert Murphy, M.D., an infectious disease expert and executive director of the Robert J. Havey, MD Institute for Global Health at Northwestern University Feinberg School of Medicine.

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“COVID is different,” Murphy says. “It is its own thing.”

If it did turn into a fall and winter virus, says Andrew Pekosz, a professor of microbiology at Johns Hopkins Bloomberg School of Public Health, that could be helpful for a few reasons.

“That makes vaccination approaches and various public health messaging a lot easier than something that’s around year-round and we’re just waiting for unpredictable surges to occur,” Pekosz says. Knowing when to expect the worst can also help hospitals and health care providers prepare for an uptick in patients.

2. New variants will continue to emerge

Remember how easy it was to keep track of the virus during those first years of the pandemic? There was alpha, then beta, then delta, then omicron. Now, the variant pool is more like a crowded alphabet soup, with new descendants of omicron emerging every few months, and with names that don’t exactly roll off the tongue — BA.2.86 and FL.1.5.1, for example.


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Get used to it, because virus experts say we can expect to see more variants in 2024. “The only constant in this whole thing really is continuous change. So people should expect that the virus will continue to evolve,” says Ziyad Al-Aly, M.D., a COVID-19 researcher and assistant professor of medicine at the Washington University School of Medicine in St. Louis.

For the most part, the virus has been making small changes since omicron arrived in late 2021, Pekosz says, and we’ve been able to adjust with updated vaccines that can target the more recent versions of the virus. But there’s no guarantee it will continue down this path.

“The worry that I have is if they evolve in a different direction and the current vaccines become obsolete, then we have to design new ones, or our current vital antivirals become obsolete and we have to design a new one,” Al-Aly says.

Individuals are not powerless when it comes to preventing new, potentially more dangerous variants, says Jodie Guest, a professor and senior vice chair in the department of epidemiology at Emory University’s Rollins School of Public Health.

The more a virus circulates in a population, the more opportunities it has to mutate, so “if we are protecting ourselves and others from COVID-19, we are helping prevent new variants come popping up,” Guest says. “Every new case is a place for a variant to happen.”

3. We’ll get closer to solving the mystery of long COVID

Millions of people who have had COVID-19 experience lingering, sometimes disabling symptoms that can interfere with everyday life — a phenomenon known as long COVID.

So much remains unknown about the condition, but that could soon change. “I think 2024 hopefully will give us more answers than we have right now,” Al-Aly says.

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A big reason has to do with new studies underway. The National Institutes of Health recently launched large-scale clinical trials to better understand, treat and prevent long COVID. One will investigate whether the COVID-19 treatment Paxlovid can help to improve symptoms of the mysterious condition. Another will study interventions to help with brain fog, memory loss and other cognitive complications caused by long COVID. Results from this research initiative, which includes a few other studies, will be published on a rolling basis.

Over the next year, Al-Aly is hopeful that we’ll also learn more about why and how long COVID occurs, or its so-called mechanism. Doing so could lend some insight on how to prevent it in the first place, he says. “I do hope 2024 will not only further enhance national awareness of the problem, but also our ability to tackle it [medically],” he adds.

4. We’ll probably have new vaccines

Given the changing nature of the virus, it’s likely the COVID-19 vaccine will be updated next year to match whatever new versions of the virus are spreading, much like how the flu shot gets updated annually, says Rachel Presti, M.D., professor of medicine and medical director of the Infectious Disease Clinical Research Unit at Washington University School of Medicine in St. Louis.

“We’re already seeing [the virus] shift a little bit away from the vaccine that we’re giving this year,” even though this new vaccine, released in September, is a much better match for the current variants than last year’s vaccine would have been, Presti says.

You might also hear more about a combined flu-COVID vaccine in 2024. That’s because vaccine manufacturers are testing a single shot that helps protect against both influenza and the coronavirus. Early trial data has produced positive results, and Phase 3 studies are in the works.

“I’m really excited about them,” Pekosz says. “All the same reasons that you would get the flu vaccine are the same reasons you would get the COVID vaccine, yet we’re seeing a really big difference in terms of people who take the COVID vaccine versus the influenza vaccine.”

According to data from the Centers for Disease Control and Prevention (CDC), roughly 42 percent of adults in the U.S. received a flu shot,as of Dec. 14, while only 18 percent of adults got the new COVID-19 vaccine.  

“So I’m hoping that a combination vaccine will really send the message to most of the population, particularly those who are susceptible to severe COVID or influenza, that, look, here’s a simple way for you to protect yourself from both of these very dangerous pathogens — one and done,” Pekosz says.

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