How to manage post-viral fatigue after COVID-19

Rest

Rest is very important for your body as it fights off the infection. That’s rest for 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 calming music can also help. If a strategy doesn’t work for you, then try another one until you find one that does.

Sleep
You may find that you need more sleep during recovery. Hospitals are often noisy and bright environments, so eye masks and ear plugs may help.

Nourishment
Try keeping your normal routine for eating and drinking. If your appetite is low, eat little and often instead of big meals. Being ill with a temperature can make you dehydrated so make sure you drink when you’re thirsty and enough so that you pass urine with normal frequency and volume. Your nurse or dietician can support you with this.

Move
Where possible, get up and move around slowly and gently a few times each day. This will keep your body mobile and help with circulation. Follow advice from your physiotherapist or multidisciplinary team and if in doubt, ask a member of staff.

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 grooming.

Allow time
COVID-19 affects people differently, so give yourself the time to recover. You may feel pressure to resume your usual activities quickly, but don’t rush.

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

Try activities
If you still feel fatigued 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’ activities
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 rests in between.

Slowly increase activity levels
People often increase their 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 and avoid pushing through fatigue.

Work
You may need longer off work than initially anticipated. A phased return works best and should be 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 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 you with day-to-day tasks so you can save energy for the activities you enjoy.

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.