BMJ: Chronic fatigue syndrome and Long Covid, moving beyond the controversy, 2021, Newman

You are right, it is better than some approaches; there is recognition of PEM. However, there's the issue of whether it is sensible for money to be allocated to these "individualised treatments". I don't think there is any good evidence that the rehabilitation approaches, for both people with and without PEM, produce any better outcomes than would be achieved by the GP being sympathetic and giving the patients with PEM a pamphlet on pacing and the patients with lung damage a pamphlet on, I don't know, maybe, singing.

There's an opportunity cost for the health system. Money spent on useless rehabilitation is money not spent on buying MRI machines, and ensuring people with cancer are seen quickly, and that people who need a hip operation get one, and that there are enough nurses.

These rehabilitation services also fill a void; they keep patients trudging through the process with hope for a while. Some of the patients at the end of the rehabilitation process do improve, almost certainly just because of the passage of time, and they become exponents of more mostly useless rehabilitation services. They are the patients who write the glowing testimonials. The patients who don't improve may well feel that they have failed. The rehabilitation services delay these patients realising that there really isn't anything to help them. The services consume the time when many patients still have influential connections and support and money and burning indignation about what has befallen them, spitting out the non-improvers to sink quietly into a state of shame and resignation.