It’s becoming sadly clear that for some people Covid-19 is not merely a short-term acute respiratory infection but a much longer-lasting illness that can scar and harm several systems in the body.While most people recover from Covid-19 within two to four weeks, 10-20% experience one or more ongoing symptoms. The list is long: severe fatigue, recurrent sore throats, breathlessness, poor sleep, muscle pain, brain fog, and depression. It’s called Long Covid and we’re learning more about it each day.A recent report by the National Institute of Health Research (NIHR) suggests that Long Covid is not a single syndrome but four different ones that can occur simultaneously. They identify patients experiencing after-effects of intensive care, those with post-viral fatigue, people with lasting organ damage, and those whose symptoms move around the body.It is well known that viral infections can act as catalysts for fatigue, gut issues, and other health problems such as poor memory and sleep disturbances that persist long after the infection has gone. The long-term effects of Covid 19 are similar to the symptoms experienced by those with Chronic Fatigue Syndrome (CFS) that develops after a viral infection in up to 80% of cases.While a virus might be the trigger, the cause of post-viral fatigue syndrome is unclear. One theory is that it may result from an overreaction of the body’s immune system that induces widespread inflammation. This is indicated by elevated levels of immune messengers called cytokines, which can cross the blood-brain barrier and potentially cause long-term changes in the brain. Others are looking into why mitochondria, the structures that generate energy within cells, are affected and how this results in fatigue.Convalescence is the gradual recovery of health and strength after illness and vital for recovery from Covid-19. A recuperative regime should consist of total rest, help with sleep and relaxation, limited exercise, and a simple diet of easily digested nutritious food.Herbal medicine can provide valuable support as part of this recovery regime and is used effectively by Medical Herbalists to support the recovery from CFS. The herbs selected for treatment will include tonic herbs to help revitalize and reduce fatigue, adrenal support to improve the response to stress, and anti-inflammatory herbs to help regulate cytokine production.The herbs selected for each person depend on the symptoms experienced. The treatment may include circulatory support to improve blood flow, particularly to reduce brain fog. Help to improve sleep and reduce depression, support for the digestive system and relief of muscle pains. In some the symptoms are cyclical and move around the body so herbal treatment can be varied in response to these changes.More help is needed for those with Long Covid. A Medical Herbalist can provide treatment to support recovery and help reduce the severity and duration of the symptoms. .