Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Biden, told Yahoo Finance that COVID-19 could become endemic in 2022 but only if certain parameters are met.

If you get "a combination of enough people vaccinated and boosted together with people who are infected and recover and have a degree of immunity — hopefully they'll wind up getting vaccinated too — and you have a virus, a variant, that has a lesser degree of pathogenicity" and it isn't disrupting society, then and only then can it be considered endemic, Fauci said.

It's why Fauci is baffled by the slow uptake of vaccines in places like the U.S., where they are widely available.

"I think virtually everyone thought, when we had a vaccine as effective and safe as the vaccines we have now, that we would get enough people vaccinated that we would … have a diminution of infection not only in the United States, but … also essentially get our arms around, as it were, the pandemic globally," he said.

But a confluence of emerging variants that have caused multiple surges and waves of cases globally, along with the lack of vaccine uptake and the lack of equitable vaccine distribution, all resulted in the pandemic still being around today.

"We were anticipating that there would be challenges, but there are a lot of conflating issues that made this a very, very complicated year," Fauci said of 2021.

It's why he remains cautious about the potential outcome of this year.

"We have a highly effective, safe intervention that a substantial proportion of the population has not made use of that is complicating our response to an already formidable challenge from a very evasive virus," Fauci said.

He worries about the remaining unvaccinated individuals, in the U.S. and globally, and how that charts the course for 2022.

"The worst case scenario is we're on our way there and we get hit with another variant that actually eludes the immune protection. I hope that's not the case," Fauci said.

"The thing that makes it less likely, but not impossible, is that by that time, you will have so many people vaccinated and already infected, that you might have a level of community protection that may not get you away from the next variant, but would protect you from the severity of the next variant."

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