Paul Garner
@PaulGarnerWoof
Followers
6K
Following
1K
Media
79
Statuses
1K
Medical epidemiologist & public health professional Professor emeritus, Liverpool School of Tropical Medicine Clarivate Highly Cited Reseacher 2023 and 2024
Joined February 2010
#LongCovid Hope and recovery. These are important messages. People find their own way and here's mine.
118
40
181
Exercise Therapy was my life before Covid-19; now it is my nemesis. Don’t try and exercise your way out of #LongCovid. Pace, Accommodate, Convalesce. When able, enjoy a gentle walk. Don’t push it. @MEAssociation @DrRobCopeland @PhysiosForME
47
311
969
Covid-19: For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion -
212
430
891
New blog on #longcovid at 6 months. Don’t try to dominate this virus, accommodate it - #LongCovid.
58
251
555
I had an unrealistic anticipated date of recovery from #LongCovid. I re-set this: if well by March 2021 it will be a bonus. This has reduced my anxiety and allows me to accommodate. Half-way way through a marathon, perhaps?.
79
53
528
Post-exertional malaise from too much mental, physical and emotional activity takes a day or two to hit. #LongCovid patients often don’t realise this, or know how to pace. How do we get this message out? @drphilhammond @trishgreenhalgh @fgodlee.
67
161
515
Understanding post-exertional malaise and pacing have been core to managing my post-viral (Covid-19) fatigue, but these words do not appear on the NHS or UK Covid-19 recovery website. CBT and GET does-why? #LongCovid
65
159
468
Covid-19 at 14 weeks-phantom speed cameras, unknown limits, and harsh penalties.
76
213
467
Paul Garner: Covid-19 and fatigue—a game of snakes and ladders -
99
162
444
Symptoms are frightening. Doctors Need to believe #longcovid patients.
Some COVID-19 patients have been called ‘long haulers’ as they continue to have symptoms for weeks or months after being infected with the coronavirus. Prof @PaulGarnerWoof, who has been sick for five months, shares his experience with the virus. #TheLatest #7NEWS
37
150
412
#LongCovid this is not anxiety and is complicated to manage well.
'I have to go back to bed about two to four times during my day'. Paul Garner, public health professor @LSTMnews, tells #5LiveBreakfast how he's managing long-term fatigue as he recovers from #COVID19. #5LiveBreakfast #LongCovid. 📱
32
129
376
I had Long Covid & met Canadian consensus criteria for ME/CFS. I have recovered: I feel that I have looked down the barrel of the ME/CFS gun and disarmed it. I write this to my fellow longhaulers #LongCovid #MECFS #postviral #longhaulers.
432
76
387
'Weird as hell’: professor recalls ‘advent calendar’ of Covid-19 symptoms
163
161
360
Delighted to contribute #LongCovid Panel @bmj_latest. We require good guidance NOW for rehabilitation drawing across disciplines using observations, patient experience, specialist opinion, and research, updated in real time. No more faffing!.
11
67
359
Hurrah! Guidance is on the way for #LongCovid in UK Lets hope they listen to Physiotherapists and patients!.
22
106
324
People with #LongCovid struggle to return to work. “People really do need some kindness and understanding” as they deal with the consequences of #Covid19 infection
16
99
315
#LongCovid is hard work navigating help. @MEAssociation @PhysiosForME have great materials, NHS sites unimpressive. Need better, more accessible resources for patients NOW.
All today, I’m covering the issue of Long Covid - which is affecting tens of thousands across the UK. Many people like @PaulGarnerWoof have had symptoms of Covid-19 for up to 6 months but are finding specialist help hard to come by . @LBC | @LBCNews .
18
112
300
“People infected in the first wave with long-Covid are just emerging, struggling to go back to work, and some are failing. We are disabled by severe fatigue, brain fog, and some people have disabling heart effects.”.
500,000 long Covid victims 'in constant pain' months after first symptoms
12
114
301
"I ran with my daughter for about 30 seconds, I was in bed for a week after that".More than a quarter of a million people, who have fallen ill with COVID-19, are thought to be suffering with symptoms that last for weeks ⤵️
32
129
279
With empirical evidence that post-exertional malaise with the chronic fatigue syndrome is a metabolic impairment, will people with #longhaul Covid-19 recover? Or is this a permanent disability? And any advice on treatment?.
53
62
273
Thanks to Peter Heywood for his analysis. After 18 weeks of #LongCovid “the virus is still in charge”.
Prof. Paul Garner contracted Covid-19 in March and is still feeling the virus's effects. "My friend in Australia said 'Paul, you are trying to dominate this disease. You are trying to beat it and go back to your levels of exercise. the virus is still in charge.'"
29
94
262
No coherent and safe guidance in #longcovid fatigue for GPs or patients. We need help with pacing-the one thing that helps me stop symptoms returning. It Isn’t even endorsed by NICE.
Clinician's Letter to NICE Results in Statement on Graded Exercise for Post-Covid-Syndrome
21
82
259
"Mitochondria, not hypochondria". New Zealand national news on links between physiological changes in #longcovid seen with MC/CFs #MECFS @OpenMedF @long_covid.
19
95
265
Coronavirus patients with even mild cases of COVID-19 are taking months to recover and suffering extreme fatigue via @ABCaustralia.
36
114
247
Revealed: the long-term severe effects of Covid-19 that could go on for months
35
120
248
I have experienced 5 major #longcovid relapses in 3 mo. This video explains why: HR>110, into anaerobic threshold. Why isn't this information more widely disseminated? WE NEED GUIDANCE NOW. Stop pussy-footing. Draw on ME/CFS research and experience.
25
99
238
Top, up-to-date guidance on #LongCovid Fatigue Syndrome .@MEAssociation. Hat-tip to Charles Shepherd; booby prize to NICE for ghastly 2013 guidelines. NICE dismiss pacing! A technique that helped me avoid pain from post-exertional malaise!
17
72
233
When Covid-19 symptoms recur with a cough or cold, people are terrified this is a new #Covid infection. Probably simply a relapse in #LongCovid precipitated by separate illness? Needs rapid practical research now as winter approaches @Dr2NisreenAlwan @drphilhammond.
11
50
216
We need stuff now! #covidlong some #COVIDー19 long haulers find cfs/ME pacing methods prevent relapse @LSTMnews.
28
85
221
#LongCovid and self-help pacing groups. As we learn to recover, we are not so lonely with our illness. We are healing, thanks to a little help from our friends.@LinnJarte @iuls @GingerheadHelen .
14
59
213
15
60
215
Talking about long term Covid-19 and how it affects your head
27
67
199
Navigating help for #LongCovid is really difficult. GP's and patients need multidisciplinary guidance NOW. No more faffing. Patients deserve better!.
Campaigners have fought hard over the past few months to bring what has become known as ‘long covid’ into the public domain
13
51
194
Recently I witnessed a) a female postdoc wanting to decline first author in deference to senior colleague; b) a male professor demanded authorship from line-managed staff as a principle (with zero contribution). Men-stop exploiting male privilege. Women-take what is yours.
5
23
195
Boris Johnson on vacation, or convalescing with #LongCovid ? Lots of us are suffering with this. I have learnt rest, and avoiding stress, is important to help recovery.
25
24
189
"Messages from Government that we will beat this disease are not helpful to people like me. I need to accept that I need to recover. People must not push through. It will make the illness come back and delay the recovery.".
Spoke to lots of people for this piece about #LongCovid - including one who quit her job, and others who fear they’re still a long way from being able to work as normal again. Calls from @GwynneMP for more support for those at risk of being laid off:.
11
51
195
#LongCovid "We need sensible guidelines. The government is simply not doing enough. medical expertise. needs to be commandeered. to work together." BBC News
11
69
197
Women have led #LongCovid, a self-organising community based on a common purpose. We are unhindered by structural sexism and institutional racism common in our societies. Let’s hope it stays that way as it becomes mainstream @NICEComms.
This is to say how impressed I am by the women scientists & advocates I worked with on #LongCovid. They're knowledgeable, intelligent, compassionate & wise. Working so hard to raise awareness & communicate facts despite their own ill health. Ladies u know who u are. You're great!.
5
38
191
Families and employers need to be considerate to colleagues with #LongCovid -bits of memory are shot and navigating long documents is tricky. and long haulers-let your brain recover!.
11
49
192
#LongCovid Facebook groups show some of us with fatigue are being diagnosed variously with #PVS or post-covid ME/CFS. For an excellent, up to date guide on this go to
9
76
189
Agree, Simon. Also make clear to people with #LongCovid what post-exertional malaise is, and to avoid pushing through exercise if present?.
Good letter in @bmj_latest from doctors with #longcovid citing #RSMLive “Before we get people exercising" need "to be sure it’s going to be safe. We need proper evaluation of cardiac and respiratory function" &. "take things slowly and in a paced measure.”
24
31
177
A short guide to #LongCovid in plain English. Thanks @mattroperbr for the opportunity and @Dr2NisreenAlwan for the sanity check.
14
63
176
"Long term effects of covid reinforce how morally unconscionable. natural herd immunity strategy is" states @DrTedros. I was infected with #Covid19 when Johnson/Cummings policy was to develop national herd immunity. Seven months of my life evaporated with #LongCovid.
Listening to @PaulGarnerWoof, Martha Sibanda & @Lythb7 share their experiences & array of symptoms, it reinforces what a dangerous virus #COVID19 is. Governments must recognise the long-term effects of the virus & ensure access to health services for those patients.
9
53
174
I am a specialist in evidence synthesis, my field for 30 years; but @edyong209 ,@zeynep and staff @TheAtlantic are streaks ahead of us in #COVID19 trans disciplinary synthesis. Hats off to the Atlantic team in keeping us up to date.
One of my favorite things @edyong209 is doing right now is weaving together expertise from the social sciences - anthropology, linguistics, psychology, history, sociology - to help us make sense of this epidemic. Disciplinary + source diversity is essential.
3
30
171
NICE 10 July state ME/CFS 2007 guidance on graded exercise therapy "should not be assumed to apply to people with fatigue following Covid-19". No statement about pacing #LongCovid
22
39
172
Exactly. Nothing on NHS Covid-19 recovery site about heart symptoms, damage, potential danger of exercise or managing dysautonomia. Multidisciplinary guidance needed NOW. Patients deserve better @MattHancock @SallySingh_ #LongCovid @LongCovidSOS.
@KateKin86106792 @PaulGarnerWoof @Dysautonomia lots research on @Dysautonomia rt.#longhauler #COVID19 friends, PLEASE be sure to see a doctor before assuming your symptoms are a post-viral dysautonomia. You Dr. needs to rule out myocarditis first, which is common in COVID. Symptoms are similar, but treatment is different.
13
45
165
Life as a #longhauler with #COVID, touching video from @Samara_Abramson. "It is like a dream that is getting longer. I don't know where I am going in life".
8
58
167
Lucy. You will get better. Just remember that.
I’ve written this to raise awareness of #LongCovid for @BBCNews but couldn’t have done it without the support of @PaulGarnerWoof and @ClaireHastie1 and @amyismall and @LongCovidScot thank you Long Covid has left me exhausted
17
8
156
#LongCovid We need guidance NOW from multidisciplinary dialogue between docs, physios, #PVS societies and patients. Research comes alongside to inform updates. @NICEComms-pull your socks up! Articulated here @LindaMottram
9
45
156
FT covers problems for people with #LongCovid, sickness benefit and returning to work “Understand this virus messes with your head and mood. It’s important to be considerate.”-advice to employers @ClareRayner6 @emmavj @LSTMnews.
7
51
150
Personal experience with #longCovid - a spectrum of conditions needing protocols for assessment and urgent guidance for GPs and patients @LSTMnews.
NEW DAILY: Some COVID suffers are reporting a disturbing post-viral syndrome that has been dubbed "long-COVID". @PaulGarnerWoof of @LSTMnews chats to @pimlicat about his own 10-week COVID experience, and why employers need to take it seriously. Listen:
15
59
147
Really appreciate this advice from Jennie for #longcovid people with post-exertional malaise, and that is certainly what I experience: the advice here is great. Thanks Jennie.
7
34
146
Hurrah! Nice publish scope for #longcovid diagnosis and management. Nice propose case definitions, including "post-covid syndrome" of signs and symptoms that develop during or after an infection consistent with #covid19 .
19
45
145
Ok @NICEComms let’s get going! It has been a month now-so let’s move ahead fast! It is a new virus but #PVS is not new. No more faffing!.
Delighted to contribute #LongCovid Panel @bmj_latest. We require good guidance NOW for rehabilitation drawing across disciplines using observations, patient experience, specialist opinion, and research, updated in real time. No more faffing!.
14
28
142
Win! On the agenda! fantastic team effort from great journalists and long haulers #bmjcovid @helenlclifton @RobinGorna @fgodlee @LongCovidSOS @LongCovidSOS.
Thank you @MattHancock for acknowledging Long COVID at the Health and Social Care Committee today! .#LongCovid #longhaulers #CountLongCovid .Full video here
11
38
143
#longcovid makes you reassess priorities. Management is about dealing with demands, constraints and choices. Today's choices may become tomorrow's demands, unless you "just say no". Thanks to my teacher @harphat.
12
14
136
Ben, I agree. We need physios, #ME charities and people with #PVS. #LongCovid need help, advice and feedback with pacing. Small self support groups have helped me.
@PaulGarnerWoof ‘We need sensible guidelines that really help people. The government is simply not doing enough with the existing medical expertise. It needs to be commandeered and brought together to work together’.MUST include #ME charities, who actually help ppl.#fileon4.
15
21
141
WHO DG Dr Tedros reaffirms the persistence of #COVID19 symptoms, and commits to research, investigation and primary care for people with #LongCovid. Starts at 3 minutes in.
6
28
129
Asher's important paper on the hazards of "taking to your bed". 1947, BMJ. Impact on all body systems as well as mental state
35
51
127
Interested in Covid-19 rehabilitation? I am! Lynne Turner Stokes is the guru for many UK covid-19 afflicted docs, and is talking with the famous @trishgreenhalgh on 16 October 18.30 BMJ seminar. @LynneTS55 #LongCovid.
14
32
126
This is the most important paragraph for me. Where is this in our narrative?.
“What about the minority groups, the single parent households, people on zero hours contracts, where long convalescence is not an option? . Pushing themselves because they have no choice will lead to further illness, suffering, and distress. They are being left behind.”.
9
24
117
Covid-19 at home-there are thousands of people still unwell-and little coordinated help from the NHS #longcovid.
Coronavirus: 60,000 may have 'long Covid' for more than three months – UK study
5
24
114
#LongCovid : a multi-symptom disorder resulting from central dysregulation of haemostatic pathways-immune, neural, autonomic, endocrine? #postviral #longhaulers diagram from Med J Aus 2002
23
41
115
Great job @helenclifton @long_covid @fgodlee and all involved in bringing #LongCovid primary health care requirements to centre stage. No more faffing! Patients, the families, and their GP’s need help!.
Just one month after mine and @JaneDJourno's @BBCfileon4 on the #longcovid sufferers who feel abandoned by health services, and @NHSEngland announce a national network of #longcovid clinics. Think that counts as impact @PaulGarnerWoof @DrColetteCoyle .
6
28
109
For #LongCovid sufferers, most of us have fatigue. Here is a great blog that is practical, well written and helpful. Pacing is NOT going to your max😃-it is about careful managing your post-viral illness. Thanks to @JennieJacques1 .
3
25
100
India, in the top five economies of the world, has evidence of #LongCovid thanks to VP's careful investigation. The suffering and potential economic impact is huge, particularly the poor.
I spoke to experts who say more facilities to treat post-Covid complications are needed in India and around the world.
0
36
99
Be careful about calling Covid-19 fatigue as “post viral”, as you may discount serious complications # via @HuffPostUKLife.
14
44
100
This is a terrific seminar, linking researchers, clinicians and patients with #mecfs and #LongCovid . "We need to listen to communities of people who have recovered from illness"-and brain-body retraining programmes really help people recover.
0
22
104
Excellent overview of #longcovid with reports from top scientists about what is happening to us.
Had coronavirus infection? Still got symptoms weeks to months later? If so, this is the show for you.
5
24
85
@SallySingh_ please consider #longhaulers for the NHS covid recovery site. Add the excellent CRESTA videos from @DrRobCopeland ? the excellent videos by @PhysiosForME? Apps to help manage fatigue? We need more advice and help than this!.
2
8
74
"I got completely frightened that I’d be ill the next day. If you expect things to happen then they do. People with long COVID sometimes . think it is simply a biomedical illness, but it’s more complicated than that.".
6
18
68
@MattHancock your NHS #Covid19 recovery website misses out symptoms, needs and advice for #longcovid spectrum. It lacks insight and detail. Please make more of an effort. Patients deserve better.
2
28
70
COVID-19-a long-lasting, debilitating illness even in people who managed the illness at home - with unknown long term consequences via @MailOnline.
11
36
63
New Covid19 messaging is deliberate, reframed so we are to blame, and set to divide us @jonjalex.
4
30
57
"The Haunting" of post viral debilitation, a comprehensive view from Jennie, thank you for your help and support as always, Jennie.
I write to validate the severity of post viral debilitation & to help bring us all up to speed. Thank you @MBVanElzakker @microbeminded2 @BhupeshPrusty @dysclinic for your time.*.#MECFS #Dysautonomia #LongCovid #COVID #COVIDー19 #postviralfatigue .*.⬇️.
2
4
61
@Dr2NisreenAlwan Long Covid advocacy, science, communication and care is led by women. Ace. That is what has made it effective at so many levels.
2
3
62
#longcovid: "the prevailing narrative about permanent damage can lead to self-perpetuating and self-validating cycle of symptom amplification".
89
11
51
Catastrophic thinking increases stress activation and contributes to worsening of symptoms in #longcovid. GP's need guidance who to investigate and who to reassure.
29
15
49
@ChandraPasma @ManeeshJuneja I think that is right. I have always said that the pacing methods with #MECFS are very helpful, but #LongCovid is a variety of #PVS with #COVID19.
6
3
49
Michelle-absolutely! #LongCovid is a post viral fatigue syndrome. The symptoms are real and people need help to recover!.
34
7
48
A study in Nature claimed exercise damaged people with post-exertional malaise from #LongCovid. We found this is NOT supported by their evidence: patients were deconditioned, the exercise was extreme, and there were no proper controls #MEcfs.
1
10
49
Oxford report efficacy without confidence intervals in a trial where they admit they gave 3000 people the wrong dose. We need the results in the public domain for appropriate scientific scrutiny-as with any research.
2
9
49
"Microclots" cause #longcovid? Cochrane review appraises laboratory studies. Concludes the particles are not clots, occur in people that are healthy or have other conditions. No justification for plasmapheresis on this count. @Cochrane_IDG #MECFS .
1
18
45
The CMC Centre for Guideline Development, Vellore: workshop in systematic review methods and evidence to decision making. Great faculty, great participants @PriscillaRupali @profsandyoliver @b5ingh
0
8
47
Great podcast - Luke’s narrative really captures it #LongCovid.
I spoke to the @guardian's award-winning Today in Focus podcast about my experiences with long-tail #Covid-19: "It's like falling into a medieval wall painting". Features fellow long haulers @PaulGarnerWoof and Iulia Hammond. Thanks @guardianaudio
2
10
40
NICE guidance on ME/CFS is the most extraordinary corruption of the evidence-based guidelines process I have ever seen. See this article in the Lancet.
89
18
42
Psychology and biology are intertwined. Dualism is out of date. Social networks shape misinformation; group conformity causes polarisation. How do we overcome the false beliefs in campaigners #MECFS #longcovid that extinguishes hope of recovery? .
89
14
42
Excellent article about #longcovid recovery and the connection between the brain and the body
9
19
43
“There is also good evidence that all types of symptoms can be influenced by anticipation and beliefs”. This helped me find a recovery path from #longcovid.
Long Covid is very far from ‘all in the mind’ – but psychology can still help us treat it | Carmine M Pariante
63
8
42
Probiotics ineffective for treating acute infectious diarrhoea. Findings of previous Cochrane review overturned by adding new high quality new trials, which highlighted publication bias and quality concerns in the smaller studies. @Cochrane_IDG
3
8
42
Chloroquine and #covid. Excellent article by @stephaniemlee. You could not make this up. Debacle of a good scientific question usurped by bad science, a fake paper, and Trump
6
15
37
Substantive benefit with CBT in #longcovid RCT based on cognitive-behavioural factors causing persistence of the fatigue. People can recover. Expectations influence outcomes.
2
8
38
Here is the TV News Item via @1NewsNZ.
"Mitochondria, not hypochondria". New Zealand national news on links between physiological changes in #longcovid seen with MC/CFs #MECFS @OpenMedF @long_covid.
5
8
39
#longcovid symptoms early on often"cyclical"; feel better between "crashes". This means #longcovid is a brain-body disorder (psychophysiological). Recent reviews miss this point completely, denying patients useful psychological approaches to help recover.
3
5
39
Just to correct people: Mar: Covid19; Sept: thought I was ill for ever with crippling fatigue, brain fog; Oct: recovered ME/CFS patient changed my beliefs, used cognitive approaches and GET, which led to my recovery; Nov: holiday. I have not been through LP #pvs
68
3
35
Thank you, Annette. This #PVS of #LongCovid is difficult to navigate, and much of the care we need comes from inside, rather than doctors “doing something”. Let’s help ourselves by working together to get through this💕.
@PaulGarnerWoof @LinnJarte @iuls @GingerheadHelen I'll add a few lines from this into my own article:
6
0
38
RCT shows CBT effective for severe fatigue with the post covid condition. Impressive effect sizes. Hans Knoop "many patients were initially skeptical that therapy would help and said they had physical problems, but afterwards they were surprisingly positive". #longcovid #MECFS
3
11
34
Emerging evidence that physical and mental health rehabilitation helps #longcovid. Hope for patients here! This matches what helped me recover. We need more research based on neuroplasticity, expectations and the biological stress response.
3
11
38