Dr Charles Shepherd, 14 April 2021
Dear Sir,
There was a serious lack of balance and information in this Newsnight report regarding the efficacy and safety of using intensifying exercise programmes in the management of ME/CFS and Long Covid.
- NICE has reviewed clinical trial and patient evidence on the safety and efficacy of graded exercise therapy (GET) in ME/CFS and concluded (in the current November 2020 working draft of the new ME/CFS guideline) that GET should no longer be recommended as a treatment.
Extensive patient evidence has repeatedly confirmed that over half of people with ME/CFS who have been treated with GET have been made worse as a result.
- The NICE guideline on Long Covid is not recommending GET for Long Covid.
- Given the fact that a significant number of people with Long Covid have undetected respiratory or cardiac/myocardial damage, and that suddenly returning to an intensifying exercise programme could precipitate cardiac arrhythmias in those with cardiac damage, a warning about this potential and serious adverse event should have been included.
- The statement regarding a research survey carried out by Professor Singh:
“Medics running Long Covid clinics…… A survey of over 1000 clinicians showed over 87% supporting the use of intensifying exercise programmes”
…was misleading and requires a correction.
This research was carried out in early April 2020 – well before Long Covid was recognised as a serious post COVID condition and one where undetected cardiac damage could be present.
The respondents were mainly physiotherapists – only 6% were physicians.
There is no reference to the safety and efficacy of using an intensifying exercise programme for people with Long Covid in this survey.
Reference: https://bmjopen.bmj.com/content/10/12/e040213
I would be grateful if you could investigate these concerns and look forward to hearing from you in due course.
Yours sincerely,
Dr Charles Shepherd
Hon. Medical Adviser, ME Association