There is now no question that Long Covid is ‘a thing’; the Office for National Statistics confirmed in December that an estimated 700,000 peple were still suffering from symptoms a year after their initial infection. And possibly not surprisingly, given that COVID is a viral illness and most cases of ME/CFS occur in the wake of a viral infection, these Long COVID symptoms have been recognised to share many characteristics with ME/CFS.
COVID has spawned a truly staggering amount of research in a remarkably short time and Long Covid is going the same way. This is cause both for frustration among the ME/CFS community (why was no one prepared to commit serious money to research into ME for all thse years and now they are pouring it in Long COVID) and celebration (at last serious money is being put into researching post viral illness). However, both research communities are at least now collaborating to investigate symptoms and approaches which are common to, and could be useful in, the management of both conditions.
For an enlightening piece on the similarities between the two conditions and the development of a common approach see Jennifer Trueland’s article in the BMA news, Long COVID – we’ve been here before.
But already the Long Covid research is becoming embroiled in the controversies that have long surrounded the diagnosis, management and treatment of ME/CFS. To what extent is it a physiological condition and to what extent psychological? And, following on from that, which management strategy, especially as regards exercise, should be adopted? This centres around the effectiveness of GET (graded exercise therapy) and CBT (cognitive behavioural therapy) which lean towards the psychological approach and Pacing, which is now the more commonly accepted approach in the ME/CFS world. This focuses on allowing damaged body systems to recover at their own pace without trying to push them. As is so often the case, there seems to be no definitive answer, each patient needing a tailored treatment which may include elements of both approaches.
For an interesting discussion of the controversy see Melanie Newman’s article in the BMJ, Chronic fatigue syndrome and long covid: moving beyond the controversy
And for another angle see Amali Lokugamage’s piece, also in the BMJ which is suggesting that there is a disconnect between medical experts in the area and the lived experience of patients, a disconnect which is exacerbated by the fact that the former appear to be able to gain easy access to media coverage ‘leaving less well resourced lay people who are affected by long covid feeling aggrieved and disempowered’.