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I am sorry but I actually think physios need to take their ethical responsibilities seriously like anyone else and admit that they have no role here. In a way I think it is condescending to suggest that it is OK for physios to 'get involved but gently' because after all they are only physios...

It could of course be to stand on a piece of paper and ....

I agree but I think it is important at this point to re-focus on the blockage with dealing with the Cochrane review. I don't think it is pressure from psychiatry or BPS in general. The people who don't want to see this review give a null recommendation are people like Glasziou, Guyatt, Gotzsche...

But that would never have happened because the idea of getting people to exercise to get them out of fatigue goes back much further - certainly to the Second World War and maybe the first. Richard Edwards was recommending exercise in the 1980s. I am not sure that GET was ever really much to do...

Yes, at least the wording of the discouragement to exercise is pretty sensible and it is heartening that the NICE draft is being taken note of.

But this is in the context of LongCovid. It would be interesting to know what would happen if all the LongCovid clinics went over just to referring for CBT. I suspect there would be quite a stink. And I am not sure what sort of behaviour the therapy would recommend?

My view on this has actually changed in a major way. The problem was never the psychiatrists. It was always the primary care physicians - who outnumber psychiatrists by about twenty to one I suspect. The psychiatrists simply found a way to sell bogus treatments to GPs. Cochrane was set up by GPs...

OK, so it is really essential that organisations like World Physio start putting out documents indicating that there is no evidence base for such a referral and making that clear to governments. Saying that rehab is a fundamental part of recovery is just dishonest and against peoples' best...

I am sure that is right. But if World Physio and the physio profession agreed that exercise is not relevant to LongCovid and got that message back to GPs and governments sharpish that might stop all the nonsense. My beef is that this document says 'be a bit careful when you exercising people'...

Who requires them to do that?

I think I am right in saying that this whole business has nothing to do with psychiatrists. That seems a complete misunderstanding of the battle. There are no psychiatrists as authors or on IAG are there? The battle is with people in Cochrane with a bias towards low tech treatments based in...

But it still makes no sense to me. Why doesn't World Physio simply put out a statement that they have nothing to offer people with LongCovid? Why don't they say if a physician refers politely send the person back saying there is no evidence based treatment? Why put out a document that despite...

Absolutely, but a physician is trained to do that. When I had acute vertigo and ended up in the stroke clinic the physician who signed me off as stroke free gave me detailed advice on exercise and its value for stroke prevention. If someone with LongCovid has a competent physician assess them...

It is worth remembering that several lines of spread at the beginning petered out. We had at least one Chinese case that didn't spread. There was the French chalet where they all had it but in the end it didn't spread. If the virus escaped from the Wuhan lab, as I am pretty sure it did, then it...

I'm sorry but I don't understand the value of this. Why not simply say that there is no reason for a physiotherapist to get involved in LongCovid since we have no evidence to base treatment on? It is full of exactly the person-tailored stuff that therapists are using to dodge the fact that they...

I tried to make out what this is really about and am still not very sure. The author is a psychology graduate doing a PhD. The emphasis is on respecting the patient's experience. That may sound fair enough but I would not be surprised if like the Bristol crowd the interest in the patient's...

But I thought the discoursers on LongCovid had deliberately avoided any mention of ME/CFS? Seems your damn ed if you do and damned if you don't.

This piece seems to me totally unhelpful. @Peter Trewhitt makes some important points but I think the situation is more complex still. I may post more later today. But essentially this is like a professor of ignoramology saying that meteorologists have too many words for bad weather and that...

Hopefully the hollow ring to these comments will have the opposite effect to that intended. When I was on an ethics committee this sort of whingeing would have gone down like a lead balloon. Let's hope the NEM are in good form.

I was 'unaware' of some of that immunology as an immunologist. I am not that impressed by Cox's grasp of the subject.