Dear Professor Garner,

It is indeed joyous news that you are on the mend. I wish you and all longhaulers well.

There are two very important caveats to be made to avoid harm to others, all factors detailed within the recent draft NICE ME/CFS guideline and/or reviewed by the committee. This includes sufficient evidence of harm to result in withdrawal of both exercise therapy and cognitive approaches to "encouraging" activity. Similar warnings have been put in place for post-covid patients by NICE.

The literature does suggest that early and sustained rest, when initial post viral fatigue strikes, results in higher probability of remission. It does sound as if you benefited from this good advice, which is as good as it gets in terms of evidence based counsel. Conversely, empirical probabilities of remission do collapse as time goes on. It is critical to