Post-Covid: Fatigue

This information has been designed to help you manage your Post-Covid fatigue. It provides information on the ways in which fatigue can affect you, and practical tips and strategies you can adopt to help manage your fatigue. If you do not see any improvement in your symptoms or are concerned, then speak to your GP, call the 111 service or speak to your health care provider.

What is Post-Covid fatigue?

Current evidence strongly suggests that fatigue is the most commonly reported symptom experienced by people with Long Covid. Fatigue is the experience of struggling to find enough energy to do the things that you need to do and feeling tired, possibly to the point of exhaustion. It is different to feelings of tiredness that can naturally arise due to lack of sleep or prolonged overexertion, but which tends to recover after a period of rest.

Within healthcare settings, including the NHS, we tend to use the word fatigue to encompass a chronic (longer lasting) feeling that does not quickly respond to one or two good nights' sleep but persists even after rest. Fatigue can arise in response to a mixture of physical illnesses and medical conditions including Covid, and/or to emotional/ psychological distress such as prolonged stress, trauma, anxiety or low mood. 

What are the common symptoms/effects of fatigue?

Fatigue can be associated with the following:

• A reduction in or lack of energy to participate in everyday tasks
• Feeling overwhelmed at the prospect of having to do things
• Poor memory / ability to focus – sometimes referred to as brain fog
• Feeling achy

Fatigue can improve or at least be better managed by the adoption of different ways of doing things, recognising the importance of restorative rest, pacing yourself, ensuring good quality sleep and addressing anxiety or low mood.

Managing fatigue

Fatigue may be extremely frustrating, but there are ways to make the most of the energy you do have. Top tips for everyday tasks:

Grooming:

• Sit when you feel you need to
• Support your elbows when a task takes longer than five minutes
• Avoid aerosols and strong scents
• Consider easy to manage hairstyles
• Wash your hair in the shower, or ask someone to help (subject to covid restrictions)

Dressing:

• Sit down when you feel you need to
• Complete lower body dressing first
• Cross your legs or raise on a step stool to reduce bending
• Choose front opening, loose-fitting clothes and safe slip-on shoes

Bathing or showering:

• Sit as much as possible when undressing / bathing /drying
• Make sure that you use stools/chairs that are designed to be used in bath/shower
• Look on-line for aids, equipment and adaptations that may be helpful or contact your local adult social care or community occupational therapist (usually through your local council) for advice on suitable products.
• Install rails (again an occupational therapist may be able to help with this) and use non-slip mats.
• Use long-handled aids for your back and lower body if you need to.
• Use a towelling dressing gown instead of drying with a towel.

Cooking:

• Cook in batches when you have the energy
• Use ready prepared meals
• Buy prepared vegetables or prepare in advance
• Eat little and often as large, heavy meals can increase breathlessness
• Consider using a kitchen trolley to reduce carrying and frequent trips
• Consider having a flask of drink or bottle of water by your chair

Household chores:

• Bring laundry downstairs each day to avoid carrying large loads or make several trips at once
• Keep a linen bin downstairs
• Iron only what is necessary and sit to complete the ironing if you need to
• Consider leaving your ironing board up
• Consider a washer/dryer or having help from others
• Could you have a vacuum cleaner upstairs and downstairs – and do a room at a time?

Out and about – plan ahead:

• Try not to do too much in one day and know where you can rest
• Consider using mobility schemes available in shops / town centres (Shopmobility) or hiring an Attendant Wheelchair from the Red Cross.
• Use a trolley rather than a basket when shopping as you can rest on it. Shallow trolleys reduce distribute weight more evenly making it easier to push, and you do not have to bend to reach items.

Doing things differently

To help you stay active and independent, it is important to look at how you go about your everyday tasks. Your energy levels will have the biggest impact on your ability to do tasks. Energy conservation techniques can be invaluable and are often very simple solutions. You will probably find that you have already begun to do things differently. Everyone has a finite amount of energy, which is different from person to person; and you may find it’s different from day to day for yourself. It is important to find your own pace and to know how much energy you feel you have. It can be useful to think of your energy like a battery.

You only have so much energy, and the energy needs to be recharged. This is done through regular rest periods and sleep. Other things which may affect your energy levels include stress, anxiety, low mood, lack of sleep or adequate rests, weather, other health needs, and time of day. In case these affect you, we have included some information on these later in the booklet. It is important to conserve your energy to ensure you have enough to last throughout the day. Alternate activity and rest throughout the day – frequent short rests are more beneficial than infrequent long rests.

If you use all your energy at the start of the day, then you may find that you have little energy left for the things that you want or need to do towards the end of the day. If you notice that you have an increase in symptoms such as breathlessness, and/or increased fatigue, or if you have done too much then rest, and think about doing things differently. Next time pace yourself.

The four Ps: Plan, Pace, Prioritise, and Position

Plan

Have a look at how you plan activities across your week, and each day. Use a diary or calendar and try to not do too many jobs in one day. Plan ahead – alternate heavy and light tasks. Take regular rests. Consider the timing of tasks – when do you feel at your best? Prepare or complete some aspect of tasks ahead. Break tasks into small steps. Keep things in easy to reach places and near to where they are needed. Have duplicate items around the house so you do not have to ‘fetch & carry’ throughout the day. Use a bag to carry several items at a time. Take things up the stairs when you go rather than going up the stairs especially.

Pace

Slow and steady wins the race. Practice breathing exercises during tasks. Doing things slowly uses less energy and less oxygen so will leave you with more energy to spare. Breathe out during a strenuous part of an activity, or when bending / reaching (“blow as you go!”)

Prioritise

Split the tasks into ‘essential’ and ‘desirable’. Try to get a balance of tasks that are essential and those that you enjoy. Try to achieve at least one ‘desirable’ task each day. Learn to say no and ask for help and accept it when offered.

Position

Think about your position when doing tasks. Sit down to do tasks as often as possible; it uses less energy If a task with your arms takes longer than five minutes, try to support your elbows/ forearms. If you need to lean to support yourself, rest forearms on support and lower shoulders. Avoid excess stooping and stretching – place items where they will be used and at waist height, use long handled tools whenever available. Have duplicate items around the house so you do not have to ‘fetch and carry’.

Do you need to print this information?

A leaflet version of the information above is available here to print out:  Fatigue.pdf 163KB