Dr Joanna Herman is right to call out the lack of care being offered to sufferers of long Covid (People with long Covid urgently need help. Why can’t we access it?, 10 March). The willingness of doctors to speak out as patients has done much to highlight the long-term effects of Covid-19.
We know that long Covid is more than one disease, all of which will need different treatments. But we do not know that graded exercise therapy is detrimental to recovery from the post-Covid fatigue syndrome. There are no such studies.
In contrast, we know that graded exercise therapy is an effective treatment for chronic fatigue syndrome (or ME), a clearly related condition. Moreover, no trials of graded exercise have shown harm to patients. We need trials of this treatment in post-Covid fatigue. In the meantime, let us not discourage patients from accessing what may be a helpful treatment, so long as it is provided by physiotherapists trained to properly deliver it.
Dr Alastair Miller Cumberland Infirmary, Carlisle, Prof Paul Garner Liverpool School of Tropical Medicine, Prof Peter White Queen Mary University of London
