More than a year after catching COVID-19, Sawyer Blatz still can’t practice his weekly rituals: running for miles in San Francisco’s Golden Gate Park or biking around his adopted hometown.

In many ways, the pandemic isn’t over for the 27-year-old and millions of other Americans. It may never be.

They have long COVID, a condition characterized by any combination of 200 different lingering symptoms, some of which, like loss of taste and smell are familiar from initial infections and some totally alien, like the utter exhaustion that makes it impossible for Blatz to walk much more than a block.

“I feel homesick for my own city,” said Blatz, a laid-off software engineer who now uses his limited energy to advocate for long COVID patients.

Federal estimates suggest at least 16 million Americans have long COVID and maybe 4 million of them, like Blatz, who contracted his only COVID infection in November 2022, are disabled by it.