Helpful Tips
Post-viral fatigue is when you have an extended period of feeling unwell and fatigued
after a viral infection.
• Fatigue is a common symptom of COVID-19 infection so it is likely that some people will
continue to experience fatigue for some time after the infection has cleared.
• At times, post-viral fatigue can develop into a long-term or chronic illness known as
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) which for many people
means they are unable to work or do many daily activities. The risk factors for developing
ME/CFS are still not clearly understood and may include genetic factors but high demand
life situations may also play a role.
• The current situation is high demand for many people, both practically and emotionally.
For example, key workers such as in health and social care and those in the food provision
lines, but also as people are trying to carry out multiple roles at home such as employee,
parent/carer, home-schooler so there may be a higher risk for developing chronic illness.
What can I do to reduce the chance of post-viral fatigue?
Initially
If you have symptoms of COVID19 it is likely that you will have some level of fatigue as part
of this. This is a normal part of the body’s response to fighting a viral infection.
• SELF-ISOLATE – Following government guidelines – remember this includes from your
family, wherever possible, even if they have symptoms or are self-isolating. If
deteriorating, seek medical help following the government guidelines.
• REST – This is most important as it allows your body to focus on fighting off infection.
In this context rest means resting the body and the mind, so doing very little – not TV,
phones or the internet. Use relaxation, breathing and meditation apps to help support
quality rest. If something doesn’t work for you try another one until you find one that
does. You can also use sensory input to help rest and relax you – like your favourite
relaxing music, blanket, fragrance, or a hot water bottle.
• NOURISH – Keep eating and drinking in as normal a routine as possible. Little and often
may help if your appetite is low, rather than big meals. Increase your fluid intake,
especially if you are not managing to eat as much. We need to drink at least two litres a
day.
• MOVE – Make sure you get up and move around a few times each day slowly and
gently to keep your body moving and help circulation.
• ACTIVITY – Keep activity levels low – both physical and cognitive (thinking) activities as
they both use energy.
• ALLOW TIME – COVID19 will affect people to different degrees so give yourself thetime you need to recover from it. The impact afterwards doesn’t always reflect the
severity of the virus – you do not have to be hospitalised to experience post-viral fatigue.
There will often be pressure to get back to your usual activities as soon as possible – do
not rush.
• HAVE FUN – do some low energy fun activities if you can, like reading or watching
things for short periods – resting regularly – see above for REST
• STOP WORK – unless you feel fully well you should stop work to allow your body to focus on fighting the infection and recovering.
Next steps
• TRY ACTIVITY – If you feel fatigue and other symptoms are ongoing after the isolation
period but you are improving gradually be gentle with yourself – try a small amount of
light activity (probably less than you think) and then REST a little. Repeat. Find the level
which is manageable – you may get more fatigue the day after doing an activity so wait
to see the result. Be realistic and kind to yourself.
• REST – as you are improving your body needs rest to continue healing. Continue to
have short rests through the day. If you’re not sure if you need a REST, take one. During
these rests – stop and do nothing and calm your mind if you can or use breathing or
guided relaxation strategies as described above.
• DAILY ROUTINE – Try and resume a daily routine for sleeping, eating and daily
activities – if your previous routine isn’t possible set a realistic one for now and follow it.
It helps the body to stabilise itself again. Gradually change it back to your normal
routine. Remember don’t rush.
• ‘THINKING’ ACTIVITIES – When starting to improve it can be easy to forget that
everyday ‘thinking’ activities such as checking emails, planning shopping, making
decisions, worrying about family members all take energy. You will need to limit these
activities, for example doing them for set times, and take REST between them. If in
doubt REST sooner.
• SLOWLY INCREASE ACTIVITY – Often people try and increase their activity levels
too quickly and set themselves back, so if in doubt go more slowly but steadily. When
we are working with people with long-term fatigue we might only increase activity every
couple of weeks. You might not need to go this slowly, but it gives you a sense of pace.
Trying to ‘push through’ the fatigue is normally unhelpful.
• WORK -You may have to take longer off work than initially anticipated and may have to
have a gradual return to work. Speak to your manager and get occupational health
advice. You may also need a Fit note from your GP.
• HAVE FUN – Don’t forget to keep fun things in life – as people start to get back to daily
life they prioritise all the things that seem necessary, but we need to balance this with
enjoyment so choose to spend some energy on fun activity too – increasing gradually like
other activities.
Moving forward
You may be starting to feel better gradually – it can take several months and often a year or
more for people to feel recovered from post-viral fatigue. If it is gradually improving keep
going. Don’t forget to keep quality REST, ROUTINE, and FUN to support your recovery.
Remember that stress and worry use energy so give yourself time and be kind to yourself.
What if I am not improving?
• SEEK ADVICE – If after 3-4 months you aren’t seeing any improvement in fatigue after
having a virus then you should ask your GP for advice so that they can check there aren’t
any other causes for the symptoms.
• SPECIALIST INPUT – if you continue to experience high levels of fatigue then
specialist services or chronic fatigue services may be available to provide further
guidance – ask your GP regarding local referral options.