An update on funding, and some better news underneath it
For twelve months our Long COVID sessions were funded through an ACT program, at no cost to clients. That funding period has now finished, so sessions are charged at our normal rates. If you saw an older version of this page saying otherwise, this is the correct information.
Here is the part worth knowing though. That program came with eligibility criteria, intake windows and a cap on how many sessions each person could have. None of that applies any more. We can now see more people with Long COVID than we ever could under the program, for as long as they need, with no hoops to get through first. Funding options are set out further down this page.
The Hardest Part Is Being Told You Look Fine
Long COVID is largely invisible. The tests come back normal, the scans show nothing, and you are left explaining to people why walking to the letterbox is now a decision rather than a walk. It is a biological condition, it is well documented, and it is not in your head.
What Long COVID Actually Means
Long COVID, also called post COVID condition, is when symptoms continue or appear after the initial COVID infection has passed. The World Health Organization describes it as symptoms usually beginning within three months of infection, lasting at least two months, and not better explained by another diagnosis.
There is no single test. Diagnosis is made by taking a careful history, examining you, and ruling out the other things that could be causing it. That process is frustrating and it is also necessary, because several treatable conditions can look similar.
What it is not is deconditioning, laziness, or anxiety. Researchers have identified measurable biological abnormalities in people with Long COVID. If you have been made to feel otherwise, that is a failure of the conversation, not of you.
It Usually Shows Up in Clusters, Not as One Thing
Long COVID affects multiple systems, which is why the symptom lists are so long and so unhelpful. Grouping them makes the pattern easier to recognise. Most people have several from one or two clusters rather than a bit of everything.
Energy and exertion
- Fatigue that rest does not resolve
- Symptoms worsening after activity, often a day or two later
- A sharply reduced ceiling on what a day can hold
Autonomic
- Heart palpitations or a racing pulse
- Dizziness or light headedness on standing
- Blood pressure drops or heart rate rises when upright
- Temperature regulation problems
Cognitive
- Brain fog, poor concentration
- Word finding difficulty
- Short term memory problems
- Mental effort costing physical energy
Respiratory and cardiac
- Shortness of breath, including at rest
- Chest pain or tightness
- Reduced exercise tolerance
Pain and sensory
- Joint and muscle pain
- Headaches
- Sensitivity to light, sound or smell
- Altered or lost taste and smell
Sleep and mood
- Unrefreshing sleep
- Difficulty getting to sleep or staying asleep
- Low mood or anxiety, often as a consequence rather than a cause
Long COVID, ME and POTS Sit on Top of Each Other
A substantial proportion of people with Long COVID also meet the criteria for ME and chronic fatigue syndrome. Estimates vary widely depending on the study and the definition used, but the overlap is large and it is clinically the most important thing to establish early. Post exertional malaise and orthostatic intolerance are both common features.
This matters because it changes the treatment entirely. If you have post exertional malaise, an approach built around progressively increasing activity can make you considerably worse. Screening for it before anyone prescribes you exercise is not optional.
Post Exertional Malaise
The delayed crash after exertion. If this is part of your picture, read this one first, before anything else on the site.
Read the PEM guidePOTS and Orthostatic Intolerance
Racing heart, dizziness and exhaustion from simply being upright. Common after COVID and frequently missed.
Read the POTS guideChronic Fatigue and ME
How we work with fatigue that has settled in for the long term, and what a realistic pacing plan looks like.
Read the fatigue guideWe Screen for PEM Before We Prescribe Anything
Some people with Long COVID tolerate and genuinely benefit from carefully individualised exercise. Others are harmed by it. The difference is almost entirely whether post exertional malaise is present, and you cannot tell by looking.
Current guidance for ME and chronic fatigue syndrome, including the 2021 NICE guideline NG206, advises against programmes built on fixed incremental increases in activity, and recommends supporting people to stay within their energy limit rather than push through symptoms. Given how much Long COVID overlaps with that presentation, we apply the same caution here as standard.
In practice that means the first appointment is assessment and conversation. Nothing physical will be asked of you on the day.
What we will not do
- Put you on a set programme that increases every week regardless of how you respond
- Tell you to push through symptoms
- Treat a crash as a motivation problem
- Prescribe exercise before establishing whether PEM is present
What we do instead
- Screen for post exertional malaise at the outset, every time
- Establish your real current baseline and work under it
- Use hands on treatment where movement is not appropriate yet
- Reassess regularly, and adjust down without any fuss when needed
What Support Actually Looks Like
A long first appointment, with no physical demand
History, symptom pattern, what a typical week costs you, and screening for post exertional malaise and orthostatic symptoms. If you have a symptom diary, bring it. If you do not, we will set one up. You will not be asked to do anything on the day that could cost you tomorrow.
Pacing support and an energy envelope
For most people this is the bulk of the work, and it is the part that produces the change. Working out your genuine limit across physical, cognitive, emotional and upright load, then building a week that stays inside it. Unglamorous, and the thing that stops the cycle.
Remedial massage, pitched carefully
Hands on treatment can ease pain, muscle tension and sleep problems without asking anything of your energy system, which makes it useful when movement is not appropriate yet. It has to be pitched correctly, so the first session is shorter and lighter than you might expect while we see how you respond.
Movement, only when and if it is right
If PEM is not present, or once things are stable, small amounts of individualised movement can help prevent the loss of strength and conditioning that comes with months of inactivity. That is a decision made on the evidence in front of us, revisited often, and reversed the moment it stops being appropriate.
Daniel's Long COVID Talk
A talk given to a group of people living with chronic lung conditions. If reading is costing you energy today, this covers much of the same ground and you can listen to it lying down.
Ways to Fund Your Sessions
With the program funding finished, sessions are charged at our standard rates. Most people use one of the following. If none of these fit, tell us and we will work something out.
Medicare, through your GP
A Chronic Disease Management plan can give you Medicare rebated Exercise Physiology sessions each calendar year. Ask your GP whether you qualify. Long COVID is generally well suited to this pathway.
Private health insurance
Most extras policies cover Exercise Physiology, Remedial Massage or both. Check your level of cover and your annual limit, since the two are often separate.
DVA
If you hold a DVA card, ask your GP for a D904 referral. This covers Exercise Physiology and Remedial Massage with no cost to you.
NDIS and Support at Home
Plan managed and self managed NDIS participants can fund Exercise Physiology directly. Older Australians can use a Support at Home budget through their existing provider.
Private, no referral needed
You can simply book. No referral, no eligibility criteria, no waiting for an intake round to open. This is the option most people use, and it is the reason we can now help more people than we could under the program.
Not sure which applies
Call the clinic on 0483 911 850 and ask. We would rather spend five minutes sorting out funding than have you not come in because you were not sure.
The Medical Side Belongs With Your GP
We are an Exercise Physiology and Remedial Massage clinic. We do not prescribe, and we do not give advice on medications or supplements. There is a lot of information circulating about drugs and supplements for Long COVID, some of it promising, much of it preliminary, and none of it something you should act on from a website.
Things genuinely worth raising with your GP include:
- Investigations to rule out other causes, if that has not been done thoroughly
- Management of specific symptoms such as palpitations, breathlessness or sleep
- Whether referral to a specialist or a multidisciplinary service is appropriate for you
- Any medication or supplement you have read about, before you start it
- A Chronic Disease Management plan, if you want Medicare rebated sessions with us
We are happy to write to your GP with what we are seeing and doing. That kind of communication between practitioners is usually where the good decisions come from, and we do it as a matter of course.
Questions People Ask Us
Are the sessions still free through the ACT program?
No. That funding ran for twelve months and has now finished, so sessions are charged at our standard rates. The upside is that the eligibility criteria, intake windows and session caps that came with the program have gone too, so there is nothing standing between you and an appointment.
See the funding options above. Between Medicare plans, private health, DVA and NDIS, most people have a pathway that brings the cost down considerably.
Do I need a confirmed Long COVID diagnosis to book?
No. Plenty of people come in while still working through it, or with a positive test months ago and symptoms nobody has formally labelled. Pacing support does not depend on having the paperwork.
That said, we are not a diagnostic service. If you have not had persistent symptoms properly investigated by a GP, do that in parallel, because there are other conditions worth excluding.
Will exercise help me or hurt me?
It depends entirely on whether post exertional malaise is present, which is exactly why we screen for it first. If you crash a day or two after activity, an approach built on steadily increasing exercise is the wrong one and can set you back significantly.
If PEM is not part of your picture, carefully individualised movement often helps, particularly with the strength and conditioning lost over months of being unwell. We will tell you honestly which group you are in, and revisit it as things change.
How long does Long COVID last?
It varies enormously and nobody can give you a reliable timeline. Some people improve within months. Others have symptoms a year or more later. Some improve to a point and then plateau.
What we can say is that pacing well tends to make the course smoother, and repeatedly crashing tends to make it rougher. That is within your influence even when the timeline is not.
I can barely leave the house. Can you still help?
Yes. Home visits are available, and a good deal of pacing work can be done without you travelling anywhere. For people who are severely affected, getting to a clinic can itself trigger a crash, which rather defeats the purpose.
Call the clinic and tell us where you are at, and we will work out the least costly way to get you support.
What should I bring to the first appointment?
A symptom diary if you keep one, even a rough one. Any letters or test results from your GP or a specialist. A list of medications. And a sense of what a typical week looks like, including the things that reliably cost you.
You will not need to change clothes or do anything physical. Come as you are.
Other Support in Canberra and Nationally
These are the non commercial resources we point people toward most often. Your GP remains the right person to advise on medical referrals.
ME/CFS Support Canberra
Runs a self help program each term covering pacing, goal setting and communicating your needs, for people living with ME, fibromyalgia and Long COVID. Delivered face to face and online in alternating terms. A genuinely useful local peer resource.
Emerge Australia
National organisation for ME and chronic fatigue syndrome, with a Long COVID information service and telehealth support. Their material on pacing and PEM is reliable and clearly written.
Canberra Health Services, Central Health Intake
The Post COVID Recovery Clinic at University of Canberra Hospital is not currently running. If your GP sends a referral, Central Health Intake will direct you to whatever services are available. Phone 02 5124 9977.
Your GP
The single most useful relationship you have in this. Long COVID is not resolved in one visit, so continuity with a GP who knows your history matters more than almost anything else on this list.
Book a Time, No Referral Needed
We are in Weetangera, Belconnen, and home visits are available if getting here is too costly. First appointments are unhurried and nothing physical will be asked of you on the day.
Definition of post COVID condition per the World Health Organization. Clinical position on activity and post exertional malaise informed by the National Institute for Health and Care Excellence guideline NG206, 2021. This article is general information and is not a substitute for individual medical advice. Accelr8 Rehab does not provide diagnosis, and does not give advice on medications or supplements. Please speak with your GP about the medical management of Long COVID.