USA: University of Washington Long Covid Clinic (Dr Janna Friedly)

Posted by sick times
https://thesicktimes.org/2025/04/21...-university-of-washingtons-long-covid-clinic/

Letter to the editors: The University of Washington’s Long COVID clinic
April 21, 2025

In February, The Sick Times published a story highlighting how educating primary care doctors about Long COVID could help address some of the challenges people face in finding healthcare for the disease. The story focused on the University of Washington (UW)’s Long COVID clinic as an example of a center working to train doctors, and included quotes from its director, Dr. Janna Friedly.

We received this letter from a reader, calling the expertise of UW’s clinic into question:

UW’s Long COVID clinic prescribed graded exercise therapy that made me worse. They shouldn’t be educating providers about Long COVID:
As a patient at the University of Washington’s Long COVID clinic, I write with concern about a recent story, “A lack of provider literacy is straining people with Long COVID. Training programs for doctors could help.”, published on February 28, 2025.

I lost faith in the clinic’s guidance recently when my physician at the University of Washington gave me an ultimatum to pursue another round of physical therapy, start taking anti-depressant medication — or risk losing the clinic’s care.

Prior to this appointment, I had finished several weeks of physical therapy that degraded my energy with each session. Week after week, I hustled to reverse my “deconditioning,” a state of physical weakening referenced in their own Post-COVID Patient Manual as one of a suite of “biopsychosocial” reasons that patients impacted by Long COVID can experience.

Except, every physical therapy session left me with crushing fatigue making it hard to work, to take care of myself, and to enjoy hobbies. Physical therapy, I was promised, would make me better. Instead, I was spending 22+ hours a day in bed to preserve my fragile strength, and now they were threatening to withhold treatment if I didn’t comply.

Throughout the Patient Manual, the physicians and clinic leaders, like Dr. Janna Friedly, who is quoted as an expert in the story, have shown they rightfully believe in “post-exertional malaise.” But they also believe in the disproven model of “Graded Exercise Therapy” (GET) for all patients. They do not consider myalgic encephalomyelitis (ME) a neurological disorder that is progressive — that is, a condition that is made irreversibly worse by activity — because no exception for recommending gradual exercise is referenced at any point in the 93 pages of the Manual.

In Session 2, Section 3 of their Patient Manual, the authors describe the stages of the “Cycle of De-conditioning.” People with Long COVID start out engaging in activity based on how they were active before they got sick, and by the end of the cycle they have “overdo[ne] it,” thereby “repeating the cycle of continuing to weaken.”

Now, I cannot leave the house unless I’m using a mobility aid as a result of pushing myself in a clinic-approved physical therapy program. Dr. Friedly and her staff cannot be trusted to train primary care providers on how to treat Long COVID and ME/CFS patients because they themselves do not respect this patient population. They push outdated treatment models and exacerbate their own patients’ illnesses.

— A UW Long COVID clinic patient