Letter to The Guardian, 12 March 2021

In response to this article in the The Guardian, I wrote the following unpublished response:

“Dr Alistair Milller, Prof Paul Garner, and Prof Peter White are wrong to suggest that graded exercise therapy should be offered to long-Covid patients before clinical trials of its efficacy have been conducted. The absence of evidence of harm from this intervention in ME/CFS patients is limited to the small number of clinical trials. Data collated from patient surveys repeatedly tell a very different story; in a 2019 survey, over 50% of patients reported deterioration in both their mental and physical health after undergoing graded exercise therapy within the clinic environment. These patient reports, together with the downgrading of evidence for rehabilitative approaches from these very clinical trials, led to NICE withdrawing its recommendation of graded exercise therapy in their recently published draft guideline for ME/CFS.

“While the lack of treatment options facing long-Covid patients is deeply regrettable, we cannot ignore the experiences of ME/CFS patients. Graded exercise may well be worthwhile in the rehabilitation of post-Covid patients who are presenting with residual deconditioning and pulmonary impairment, but for those meeting the diagnostic criteria for ME/CFS it will likely prove ineffective and potentially harmful.”