How to manage post-viral fatigue after COVID-19

Self-isolate
Please follow government guidelines. Remember, this includes isolating from your family/ household wherever possible, even if they have symptoms or are also self-isolating. If you deteriorate, seek immediate medical help following government guidelines.

Rest
Rest is very important for your body as it fights off infection. You need to rest both your body and mind. Keep television, phones and social media to a minimum. Relaxation, breathing and meditation can all support quality rest – the NHS Apps Library has free tools you can try. Sensory relaxation tools such as fragrances, blankets, and relaxing music can also help. If a strategy doesn’t work for you, try another one until you find one that does.

Sleep
You may find that you need to sleep more. Make sure you follow healthy sleep habits: ensure your room is as dark as possible, have a bedtime routine, and avoid caffeine, eating late and using electrical items before bed.

Nourishment
Try to keep your normal routine for eating and drinking. Being ill with a temperature can make you dehydrated so make sure you drink fluid when you’re thirsty and enough so that you pass urine with normal frequency and volume.

Move
Get up and move around slowly and gently a few times each day. This will keep your body mobile and help with circulation.

Keep activity levels low
Both physical and cognitive (thinking) activities use energy. Try to do only a small number of these activities each day, including basic activities of daily living, such as washing and dressing.

Allow time

COVID-19 affects people differently, so give yourself time to recover. Its impact afterwards doesn’t always reflect the severity of the virus and you don’t have to have been hospitalised to experience fatigue. You may feel pressure to resume your usual activities quickly, but don’t rush.

Have fun​
Do some low energy activities that you enjoy, such as reading or watching TV, for short periods with regular rests.

Stop
Please follow government guidelines. Unless you feel fully recovered after self-isolation, you shouldn’t work. Your body still needs to focus on fighting the infection.

Try activities

If you still feel fatigued after self-isolation but overall, you’re improving, keep being gentle with yourself. Slowly try a small amount of light activity that is manageable (probably less than you think) with regular rests. Be mindful that you may feel more tired the next day. Be realistic and kind to yourself.

Rest
Your body still needs rest to continue healing, so take short breaks throughout the day, even if you don’t think you need to. Stop and do nothing, calm your mind, and try breathing or guided relaxation techniques.

Daily routine
Routine helps your body to stabilise itself. Slowly resume your routine for sleeping, eating and daily activities. If this isn’t possible, create a realistic one to follow for now and gradually adjust back to your normal routine. Remember, don’t rush. If you’re having difficulty sleeping, check out the tips and advice from NHS Every Mind Matters.

'Thinking' activites
Continue to limit everyday ‘thinking’ activities, such as emails, planning shopping, making decisions, as these all use energy. Try to do them only for set times with regular rest in between.

Slowly increase activity levels
People often increase activity levels too quickly, which can set them back. Occupational therapists working with people with long-term fatigue may only increase activity levels every couple of weeks. So, go slow and steady with activities and avoid pushing through fatigue.

Work
You may need longer off work than initially anticipated. A phased return works best which is planned with your manager and, if you have one, your occupational health department. You may also need a fit note from your GP. Try to avoid returning to work too soon and without the adjustments that you need to manage fatigue.

Have fun
Remember the fun things in life. Often people only prioritise things that seem necessary as they return to daily life, but it’s important to have a balance. Allow others to help with day-to-day tasks so you can save energy for the activities you enjoy.

You may start feeling better gradually. Your recovery from post-viral fatigue could take several months to a year or more. As you start to gradually improve, remember to keep a balance of quality rest, routine and fun activities. Stress and worry use energy, so give yourself time and be kind to yourself.

Seek advice

• If after building up the pacing of your daily activities, you don’t see any improvement in what you can do, then you should seek medical advice by speaking to your GP.
• Find out more about pacing your daily activities in the 'How to conserve your energy' guide. 
• If you continue to feel extremely fatigued, then specialist fatigue services may be available to provide further guidance. Ask your GP about referral options.

If you have any doubts, please seek medical advice via current routes.