Germany's hidden pandemic legacy: ME/CFS and the long shadow of COVID

Six years have passed since Germany's first confirmed coronavirus case in North Rhine-Westphalia. Since then, around 40 million covid symptoms have been recorded across the country. For some, the covid has left lasting damage—including a rise in cases of ME/CFS, a severe and often misunderstood illness.

Philipp Damerau, a 14-year-old from Minden, fell ill two weeks after returning from a trip to the U.S. His covid symptoms persisted, leading to a diagnosis of ME/CFS. The condition, which can follow viral infections like covid, disrupts the immune system, nervous system, energy production, and circulation.

ME/CFS is marked by extreme fatigue, muscle pain, sleep disorders, and cognitive difficulties. A key feature is post-exertional malaise (PEM), where even minor activity worsens covid symptoms. Yet diagnosis remains difficult—no specific lab tests or biomarkers exist, often leading to delays or misdiagnoses.

Germany now faces hundreds of thousands of ME/CFS cases, with over a million people experiencing persistent covid symptoms, including Long COVID. Not all Long COVID patients develop ME/CFS, but some meet its strict diagnostic criteria. Despite the growing numbers, no approved causal treatment exists. Therapy instead focuses on symptom management and pacing to conserve energy.

Data from the Robert Koch-Institut, as of February 2026, does not provide exact figures for those in treatment for Post-COVID or Long COVID. The condition, however, is recognised as a chronic multisystem disease that can emerge after various viral infections, not just covid.

The pandemic's long-term effects continue to challenge patients and healthcare systems. With no cure for ME/CFS, management relies on symptom relief and careful energy planning. For many like Philipp Damerau, the illness has reshaped daily life, highlighting the need for better research and support.