GET and CBT were developed to reverse deconditioning and change a fear of exercise.
This approach has now been rejected by NICE (draft) and the CDC because of poor quality evidence and potential harm.
Doctors get little or no training on ME/CFS and if the do are taught an incorrect psychological model. The NICE guidelines perpetuate a misunderstanding and are still in place. Most doctors are unaware of the history and biomedical research (>10,000 papers).
Thread of some quotes from Michael Sharpes #LongCovid presentation
"I help to set up a Post Covid clinic in Oxford which is based in a respiratory department but which is multiple disciplinary. And so I've had some clinical experience of the kind of patients that we're seeing"
"What's very striking in some of our patients is what you might call health anxiety. They are very focused on bodily symptoms, they're worried."
"Anxiety is prevalent in this population"
"A third to a half of patients have significant anxiety and because of that fearfulness they may avoid going out and they may spend a lot of time seeking information about their condition because it's known to be a little mysterious and they may seek a lot of medical care"
"The definition of long Covid is people having symptoms going on beyond 12 weeks. The number of people who have had Covid in the UK makes this an almost overwhelming problem."
"We do chest x-rays, CT scans and full lung function tests. Some people have evidence of scarring, some people have evidence of an inability to absorb oxygen properly. But most people have normal tests."
"For these people it really comes down to fatigue, to muscle strength and also to what the physiotherapists call dysfunctional breathing, so after Covid people breathe a little bit differently."