Real science is never settled, and anyone who has certainty on such things is not qualified to discuss it.
I would consider Long COVID a form of chronic fatigue. Having suffered for 2+ years with such issues of uncertain etiology (but preceded by COVID and coincident with a massive EBV reactivation), I found this discussion interesting. I am slowly regaining strength, but it’s very much a 3 steps forward, 2.8 steps back sort of thing.
The article is pretty good—I would say it dovetails well with my own personal observations. Worth a read if you are afflicted.
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a disabling and complex disorder, and according to the U.S. Centers for Control and Prevention (CDC), is estimated to affect up to 2.5 million Americans. Up to 90 percent of sufferers are undiagnosed. The CDC estimates the disease costs the U.S. economy about $17 to $24 billion annually in medical bills and lost income.
The condition causes extreme physical and mental fatigue that lasts for at least six months and more often affects women than men. Symptoms worsen with physical or mental activity and, unlike normal experiences of fatigue, don’t substantially improve with rest.
Too much exercise can lead to postexertional malaise (PEM) in which sufferers have less energy after exercise and may not recover their previous strength for days (or longer). The issue of exercise is highly controversial in the field of CFS. Some research has suggested that a program of graded exercise therapy (GET) can benefit patients, but an entire issue of the Journal of Health Psychology was devoted to calling this approach into question. The question of whether exercise is good for patients—and if so, how much—is still an unanswered question, as evidenced by ongoing research at the Mayo Clinic.
Though there are subtle differences in their approaches, both the CDC and the ME Association of the UK advise that exercise should be paced and gradual—and typically under the guidance of a trained professional.
WIND: giving it a fancy name(myalgic encephalomyelitis) is classic medicine: “we have no idea, so we’ll make something up so we can pretend we understand it”. Well, I suppose you have to give it some technical name. Yet medical science knows next to nothing about chronic fatigue, and even less about how to treat it.
I’ve called out only the Exercise section, because it is indeed an area of difficulty. Over nearly three years, I have had to throw away past experience and completely rediscover what I can handle. Sometimes I am surprised—stronger than expected, for for most of several years it was a “try and die” sort of thing, meaning even modest efforts could result in days (or longer) of payback—very unpleasant.