Trial By Error: NICE On Exercise And Post-Covid Syndrome

David Tuller


By David Tuller, DrPH.

As post-covid syndrome has emerged as a major public health concern, so has the likelihood that members of the biopsychosocial ideological brigades will roll out their typical interventions for the “long-haulers”–patients suffering from profound exhaustion and other symptoms for many weeks and months after getting infected with the coronavirus. The situation has created an unforeseen dilemma for UK’s National Institute of Health and Care Excellence, which is currently in the process of revising its misguided 2007 guidance for what it then called chronic fatigue syndrome/myalgic encephalomyelitis and now calls ME/CFS.

The panel that created the 2007 document was dominated by cognitive behavior therapy and graded exercise therapy proponents, so those interventions ended up as core treatment recommendations. Three years ago, NICE conducted a perfunctory review and decided that the guidance did not need updating. An onslaught of negative public comment followed, along with the revelation (on Virology Blog, via a freedom of information request) that the expert review panel was remarkably free of diverse voices. NICE reversed itself and launched a full-scale revision process.


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