Long COVID

The following pages have advice on the management of Long COVID and the symptoms and support for managing the condition.

• Long COVID Workbook – downloadable booklet about management of Long COVID from NHS Scotland
• NHS inform
• Chest Heart & Stroke Scotland – this charity has information and support groups for Long COVID
• Asthma + Lung UK – Long COVID advice
• Long COVID Physio – an international peer support, education and advocacy, patient-led association of Physiotherapists living with Long COVID and allies
• British Heart Foundation – Long COVID advice
• C19-YRS – Long COVID advice. The NHS funded app is no longer free to use.
• Long COVID Scotland – a volunteer-led charity run by people living with Long COVID on behalf of those living with Long COVID. Collectively advocate on employment and benefits, research and local and national policy.
• NHS England COVID Recovery – 4-5 minute videos giving practical advice to help you recover from COVID-19. You can use them as self-management guides.
• Long COVID and Diet – the association of UK Dietitians resource for dietary advice to support Long COVID
• Friends and Family Leaflet – a leaflet you may wish to share with friends and family to help understand Long COVID and support you better

Support groups

• Long COVID Support
• Long COVID kids

Fatigue is the most frequently reported symptom of Long COVID. There are some strategies which can help manage your energy – different ones work for different people. You may wish to try one at a time. The RCOT website has some practical ways to use the “5Ps” to manage your energy.

• Post viral-fatigue and conserving energy – Royal College of Occupational Therapy
• Activity diaries
  • Fatigue in long Covid: Using an activity diary to monitor your symptoms on Vimeo
  • MS Word simple diary
  • Energy and Symptom Diary – highlights what activities impact on your symptoms
• Spoon Theory
• Energy Envelope
• Introduction to fatigue in long COVID on Vimeo
• Understanding your fatigue on Vimeo

Sleep is important for replenishing energy levels and repairing the body. Many people with Long COVID feel that their ability to sleep and their sleep quality have got worse since COVID. The following pages help with advice and support to improve your sleep.

• Sleepio
• The Sleep Charity
• Sleep Foundation
• BetterSleep
• Wellbeing HUB – sleep

Brain fog is the term coined for those with memory and attention impairments. It is one of the most frequently reported symptoms of Long COVID and impacts on many daily activities. The following pages can give some helpful tips on how to manage these problems and ways to improve your memory and attention gradually.

• NHS inform
• Long COVID Physio – Cognitive Dysfunction
• Mindfulness Breathing exercise
• NHSGGC Mindfulness App

Breathlessness has been one of the main symptoms of Long COVID and is often not caused by any damage to the lungs or respiratory systems.

Many people with Long COVID do not have any abnormality shown on x-ray or CT, but have debilitating symptoms of breathlessness.

The following pages have exercises and advice to improve the efficiency of your breathing if you have “dysfunctional breathing” or a “breathing pattern disorder”.

The breathing exercises may also be helpful if you have been diagnosed with anxiety, asthma or COPD, as an adjunct to medical management. There are also sections on cough management.

• Physiotherapy for Breathing Pattern Disorders
• Breathing Physio
• Scottish Opera Breath Cycle II (Long COVID)
• Calm App

Your mental health is as important as your physical health – while you are recovering from COVID or living with the ongoing symptoms, it is understandable that many people feel a decline in their mental health.

It is important to address these issues to prevent worsening, and there are many ways to self-manage milder symptoms.

If your symptoms are worsening or you no longer feel that you can keep yourself or others safe, please contact your GP or call NHS24 on 111 or 999 depending on the severity.

The Long COVID Service is not a 24 hour service. Communication (email and telephone) is not monitored out of working hours

• NHS – 5 steps to mental wellbeing
• Every Mind Matters – website with resources for managing your mental health including relaxation, meditation and strategies
• Stress Management Society
• Wellbeing services – South Glasgow – web links and virtual groups for various aspects of mental health for those with GPs in the South of Glasgow
• Wellbeing Scotland
• Meditation and Sleep Made Simple – Headspace
• Breathing Space Scotland – a free, confidential, phone and webchat service for anyone in Scotland over the age of 16 experiencing low mood, depression or anxiety.
• Lifelink – can offer support to anyone who is struggling to cope with everyday stress or is feeling anxious or depressed. 1:1 counselling available and a Glasgow based service.
• Samaritans – for anyone who’s struggling to cope, who needs someone to listen without judgement or pressure. This is for if you are in crisis or to prevent a crisis.
• Daylight – clinically proven digital treatment that uses Cognitive Behavioural Therapy (CBT) techniques to help people gain control over their anxiety.
• Shereen’s Story – Mental Health Foundation – Shereen’s story of her experience of Long COVID

Those with Long COVID often struggle to return to work, study or unpaid work. The following webpages offer support and advice about how to plan your return to work, what to do if you have not been treated fairly by your employer and where to turn if you are exiting work or seeking new employment.

• ACAS – free, impartial advice on workplace rights, rules and best practice
• Access to Work – Government based agency offering support to those with a disability
• Jobcentre – Support and advice on benefits and employability
• The Advocacy Project – human rights based organisation that supports people to have their voices heard and be empowered to be involved in decisions that affect their lives
• The Federation of Small Businesses – for those self employed or running smaller businesses – advice, financial expertise, support and a powerful voice heard in government
• Govan Law Centre – a free legal resource – a charity challenging poverty, discrimination and disadvantage. They specialise in housing, landlord and tenant, homelessness, welfare rights, money advice, social services, consumer and debt

People living with Long term conditions often need to reduce their working hours or stop working to manage their condition. This may inevitably have an impact on their finances. The following pages may be able to help and guide you to money management or signpost you to grant or benefits to help.

• Support and Information Services (NHSGGC) – a service within the NHSGGC who can advise on financial, social, educational, lifestyle issues and support groups and guiding through the complaints process.
• Citizens Advice Scotland – help for benefits, debt and money, housing, work, family, law and courts and immigration for those living in Scotland.
• Money Matters – a Welfare Rights Service, financial capability service based in Glasgow.
• Advocacy.scot – support for those with Long Term Conditions – eg – advice for applying for Adult Disability Payment / ADP (previously known as Personal Independence Payment / PIP)

Some people with Long COVID have been experiencing palpitations – a sensation of fast or inconsistent heart beats in their chests or dizziness. In some cases this is cardiac related, but many have been medically assessed and the symptom is not due to any damage to the heart.

If you have this symptom and cardiac cause has been ruled out then this may be classed as dysautonomia. This is a condition which many people have and can be managed with the right advice and treatment.

• Dysautononomia Support
• PoTS-UK
• Standing Up To PoTS
• NHS Page for PoTS
• Stop Fainting

With Long COVID, you may find that you struggle with the minimal amount of activity due to fatigue.

If you are at a level where you can manage your activities of daily living without a set back in your symptoms then you may be ready to consider gradually introducing some additional activities.

Please ensure you are not pushing beyond what your energy levels are tolerating and allow for at least 3 days after introducing a new activity before repeating or progressing, especially if you have Post exertional Symptom Exacerbation (PESE, also known as PEM). .

Consider what you have planned before and after the new activity and ensure you are using a paced approach (see fatigue section regarding the 5Ps).

Please stop or reduce what you are doing if your symptoms are worsening and re-evaluate if you are ready to be more active.

The following links will provide you with some ideas for introducing a new activity or exercise:

• Live Active is a service which is available in the NHSGGC council areas. Your GP or an NHS clinician can refer you. There are Live Active advisors who help you build the confidence you need to make positive lifestyle changes. They will personalise their support to make sure it meets your needs. With one-to-one catch-ups and supported activity sessions. These sessions can be based at your local council gyms for those who live within NHSGGC. The vitality classes may be a good starting point for those struggling with finding a starting point for exercise with Long COVID:
• The Scottish Ballet Long COVID programme helps posture, alignment and body confidence and its creative elements address your whole being
• NHS Sitting exercises
• NHS Pilates – a series of introductory Pilates exercises
• Suzy Bolt Long COVID Yoga – videos of meditations, educational sessions and Yoga based gentle exercise

The following pages will signpost you to templates you may use for managing your long term condition

• WRAP – wellness action plan, an example of a plan which can be useful for managing your condition
• Work WRAP – Longer version of the above WRAP with sections more relevant to work

For reduced or loss of sense of smell there are charities which support and sell packs to rehabilitate the sense of smell

• Abscent
• Smell Taste

• For people with noise sensitivity after COVID, many have found that noise Reducing earplugs helpful.
• Visual decline – please refer to your local opticians
• Visual sensitivity – some have found that wearing coloured glasses lenses relieving, or wearing a cap to be helpful to shade the light from above.

Ask Sara – Impartial advice about equipment to help make daily living easier

Kitchen Aids – A list of small aids that can support you when completing kitchen tasks

Household Aids – A list of small aids that can support you when completing kitchen tasks

Personal Care Aids – A list of small aids that can support you when completing personal care tasks

Certain medical conditions need to be declared to DVLA. Some symptoms of Long COVID may impact on your ability to concentrate or safely manoeuvre a vehicle. If you do not declare a new or worsening health condition or disability, it may result in a fine or prosecution. Please see the DVLA website for further information and an A-Z list of conditions.

These pages have adapted fatigue strategies for those who are neurodivergent (eg – Autism or ADHD).

• The Neurodivergent Spoon Theory is a helpful tool which has adapted the Spoon Theory for those who are neurodivergent
• How to Use Pacing Systems — Insights of a Neurodivergent Clinician (neurodivergentinsights.com)

Building on the success of the long covid service NHS GGC has opened services to those living with long-term conditions.  More information on how to refer to the My Health – Living with Long-term Conditions Service can be found here. 

Below you will find presentations and resources relating to the Long COVID group sessions.

The “notes” section of the PowerPoint presentations has a script for each session.

Session 1 – Introduction

Session 2 – Post COVID Dysautonomia

Session 3 – Fatigue (Part 1)

• Energy and Symptom diary
• Living in your Energy Envelope tool

Session 4 – The Breath

Session 5 – Brain Fog (Part 1)

Session 5 – Brain Fog Strategies (Part 2)

Session 6 – Fatigue (Part 2) and Sleep

Session 7 – Wellbeing

• Links for Support

Session 8 – Planning for the Future

• Workplace Adjustment Passport
• Return to Work Problem Solving Template
• Self Management Toolbox