An initiative, funded by the Public Health Agency of Canada, has published guidelines for Post COVID-19 Condition. The website is here. On that website is this list of the full set of recommendations. You can filter by the type of recommendation and drill down to details on how they developed each recommendation - although I didn't see a list of the actual studies used to support each, just summary statistics on outcomes. Perhaps I missed that The recommendations recognize PEM as an aspect of Long COVID and recommend pacing for those with PEM. They also have some very detailed recommendations for energy conservation in the drill down here. But weirdly, the references used to support the pacing recommendation included studies that are not pacing as used for PEM (e.g. pacing up, White 2011). "The CAN-PCC Collaborative suggests using rest/pacing for adults with confirmed post COVID-19 condition and post-exertional malaise or post-exertional symptom exacerbation (conditional recommendation; very low certainty in the evidence). Remarks: The rest/pacing treatment that was used in the included studies was as follows: Tanguay 2023 - 14 hours of telerehabilitation therapy (physiotherapy and occupational therapy) over 12 weeks; Parker 2022 - 7 weekly telephone calls with a clinician; White 2011 - Up to 15 in-person therapy sessions provided by occupational therapists over 36 weeks; Kos 2015 - 9 in-person therapy sessions provided by an occupational therapist or a physical therapist over 3 weeks."Muddled. Hard to see how well they understood PEM, pacing or what these studies actually evaluated. They also recommend CBT based on very low evidence and a claim of small benefit and "trivial undesirable effects." The description of the intervention and what it was supposed to achieve is unclear. Finally, they recommended activity/exercise for PCC with PEM in research only because of the risk of PEM. Moderators - could you please move if this is duplicative or in the wrong place. Edited to add sentence about energy conservation
