Dr. John Lambert:

Eight years ago, the UK National Institute for Health and Care Excellence, NICE, guidelines recommended graded exercise for chronic fatigue syndrome. That was based on a particular study but, two years ago, the NICE guidelines debunked that study. The NICE stated that it is a bad study and not to follow that advice because if those patients do graded exercise, they crash. I always tell people that it is three steps forward and four steps back. Half of the patients I see coming in have been told by GPs, occupational health or others to do graded exercise. I send letters to those medical practitioners to ask them to look at the guidelines and update themselves on the treatment of chronic fatigue syndrome as the treatment they are recommending does not work. This is another issue. It has less to do with brain neuroinflammation. When people with these conditions push themselves, they get an almost immunological crash. They just crash. We do not know whether it is mitochondrial or immunological. We are focusing today on neuroinflammation but there are other conditions that are caused by Covid. Graded exercise does not work in such cases and should not be used. We need physiotherapists and neurophysiotherapists to send the message for people to build up their immune system and be able to listen to their body so that they do not push themselves to the point of collapse, which is what is currently happening with many of the long Covid patients.