Long Covid Rehabilitation

Long Covid is a multi-issue debilitating physical cognitive and mental dis-ease that results in about one in five people who have had Covid-19. At this time, many different rehabilitation programs are being tested worldwide to try to alleviate Long Covid which appears to have a great variety of ways that it attacks our physical bodies and cognitive abilities, and which can last from weeks to what looks like possibly years if not treated with a more multi-pronged less stress inducing approach to healing.

At Gateways to Transformation, our new Long Covid Program is based upon several physical research studies regarding rehabilitation for Long Covid, however, ours has added recovery in the cognitive mental health arena as well, making this a more comprehensive program.

The mental health aspect of this component of the program is addressed much like a person with a (TBI) head injury. We begin with assessing the cognitive and physical capacity, and making sure the client is getting enough rest. From there, we slowly increase the ability of the cognitive and physical use, but not pushing past what the brain and body can physically handle. Through rest, just enough mental therapy and exercise to avoid collapse, we let the body, brain and essential connections in the brain come back into balance. We also utilize healthy food and vitamins to heal the whole system that has been disrupted by Long Covid. As the client slowly gains strength both mentally and physically, the load is increased slowly to keep recovery progressing.

An essential part of this type of rehabilitation is that it is not rushed. Healing for this dis-ease has to be incremental, not pushing your physical and cognitively damaged areas to heal fast as most people are used to doing. This type of healing has to be done in small steps and not hurried. If rushed, the client can overwhelm or crash in a way that leaves them physically, emotionally, and cognitively exhausted. Working closely with the psychological counselors, occupational therapists, and medical staff allows the client to be monitored closely to ensure the best healing outcome.

Utilizing a staff of licensed therapists, occupational therapists, a psychiatric nurse and collaborating with Dr Gwendolyn Diaz, AyD, Gateways to Transformation’s 3-to-6-month intensive Long Covid outpatient program can help our clients to heal.

The components of this program include a combination of medical management, occupational therapy and mental health therapy to initiate a holistic complete management and recovery from Long Covid. This program was built and expanded upon successful outcomes in the UK and Europe and includes several segments so as to treat the whole person.

Step One: clients are onsite in transitional living accommodations during the crucial first month (sometimes longer if needed). Clients work with all therapy and medical staff at this time.

Step Two: This step includes either a less intensive onsite four day a week routine with therapists and medical staff, or alternatively, tele-therapy online for 4 days a week M-Th to continue sessions and help clients to successfully move back into their lives.

Step Three: includes both occupational therapy and counseling therapy. This step down is a support group that meets approximately once a week to go over what is and isn’t working for clients and what they can do to optimize their lives after Long Covid.


The program is designed by Alisha Adrian B.S., M.S., LPC, TP, ET, utilizing her extensive work with head injury clientele while working with Carol Schneider PhD. Additionally, it draws on Adrian’s experience working with doctors, therapists and occupational therapists in a TBI trauma team in the Boulder Colorado area to gradually increase both physical and mental abilities.

This program will work both individually and in small groups to minimize overload of either physical or mental states, while also insuring organic healthy food and vitamins that work to help rebuild your system and bring it back to a more optimal balance.



From Dr. Gwendolyn Diaz, AyD: Ayurvedic Clinical Management for Long COVID

Following three aspects are considered while preparing this protocol:

Knowledge from Ayurveda classics and experience from clinical practices

Empirical evidences and Biological plausibility

Emerging trends of ongoing clinical studies

The pathophysiology of infection due to Long COVID from the Ayurvedic perspective can be explained by considering it as primarily infectious in nature from the Covid-19 virus. The degree of vitiation is variable owing to magnitude of infection or individual immunity of the affected person.

The generalized protocol for management of Long COVID involves performing proper systems detoxification, administration of immunomodulatory supplements/herbs and specific body therapies. In addition, adopting ethical code of conduct, wholesome food habits as well as lifestyle and administration of other supportive psychological therapeutic measures, will benefit in managing Long COVID.

The traditional principles of management in pandemic diseases can be precisely understood through the integrative method. Ayurvedic physicians have described performing the detoxification process in the preliminary stage, which may alleviate the viral entry into the body or may reduce viral load in the infected individual.

When Long COVID stays in the body, the Ayurvedic physician must open up appropriate pathways for deep seated virus to clear the body through Rasayana therapies. Administration of Rasayana therapies may delay the process of pathogenesis by increasing the immunity and eliminating the viral toxic effects on the body. Specific herbal therapies, relevant to the individual, may help in completely alleviating the residual viral load. Long term lifestyle modification is a key factor in completely eradicating symptoms of Long COVID from the body.

Initial assessment is given upon entry to the program where there is a comprehensive analysis of the systemic response to the Covid-19 virus in the body. From there, development of an individualized treatment plan consisting of proper detoxification, right diet, lifestyle management practices, and herbal/supplemental protocols will bring the body back to homeostasis. Symptoms such as shortness of breath, anxiety, sleep, fatigue and brain fog are addressed at a root cause level, thereby providing lasting relief from ongoing debilitating symptoms.


National Clinical Management Protocol based on Ayurveda and Yoga for Management of Covid-19


AYUSH BHAWAN, B Block, GPO Complex, INA, NEW DELHI – 110023


The mental health and occupational therapist segment of the program addresses Long Covid’s impact on mental health such as:

  • Self-worth/self-esteem
  • Self-compassion
  • Self-efficacy
  • Depression/anxiety
  • Low tolerance for completing simple tasks
  • PTSD-trauma
  • Grief work

  • Wellness Therapy

  • Following a more head injury trauma guideline of allowing yourself to slow down and not push your recover immediately and learning to set small goals to move forward towards cognitive health

  • Hygiene
  • Sleep hygiene
  • Ability to negotiate your daily life

Occupational therapists utilize programs and assessments to determine what the client needs and starting out in a way to not overwhelm and over stress will help with the ability to work on taking care of themselves while assisting them to be gentle and kind to themselves. PTSD and trauma work is very important as well as grief work, hygiene, and self-esteem. It is extremely important that clients learn to take life at a slower pace and allow the body to heal. Long term health is as much the physical healing as it is the mental healing.

For many, it is hard to even do the simplest of tasks, i.e., bathing, brushing their teeth, and for some, just getting out of bed. Breath work and taking things slowly will help build strength throughout treatment. While much of the work is just doing the simple tasks, celebrating small victories and goals is just as important. Creating a plan and goal sheet will help clients see their progress. Progress notes will also be kept by therapists to be used as a guide for future clients. This program will can be submitted to insurance as an intensive outpatient program.


The Center for Health Statistics ( www.cdc.gov/pressroom/nchs_press_releases/ 20222/202206.htm) are now showing that 1 in 5 people who have had even a mild case of Covid develop Long Covid symptoms.

  • Some may develop debilitating symptoms weeks or months after a mild case and also realize that their health issues are a result of a prior Covid infection.
  • Patients suffer from a wide variety of disabling symptoms including cognitive issues and crippling fatigue that can leave them unable to work or live their lives in a healthy way.
  • Right now there is little understanding of Long Covid nor any proven treatment or cures.
  • Research and programs are being tried around the world to try to work with this disease.


A recent article of what seems to be a successful research program is the physical basis of what our program at Gateways to Transformation is based upon. Unfortunately, the research only looked at the physical medical aspect of rehabilitation. The Gateways program adds in a more comprehensive holistic aspect adding in wellness, occupational therapy along with psychological therapy to address the clients psychological trauma that they incur as they move through the various elements of this disease. This we feel adds in the parts of the program that are missing in most other programs being built to work with this debilitating condition.


Per the CDC https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/ index.html

People with post-COVID conditions can have a wide range of symptoms that can last weeks, months, or even years after infection. Sometimes the symptoms can even go away or come back again.

Post-COVID conditions may not affect everyone the same way. People with post-COVID conditions may experience health problems from different types and combinations of symptoms happening over different lengths of time. Though most patients’ symptoms slowly improve with time, speaking with your healthcare provider about the symptoms you are experiencing post-COVID could help identify new medical conditions. For some people, post- COVID conditions can last weeks, months, or years after COVID-19 illness and can sometimes result in disability.

People who experience post-COVID conditions most commonly report: General symptoms (Not a Comprehensive List)

  • Tiredness or fatigue that interferes with daily life
  • Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”)
  • Fever

Respiratory and heart symptoms

  • Difficulty breathing or shortness of breath
  • Cough
  • Chest pain
  • Fast-beating or pounding heart (also known as heart palpitations)

Neurological symptoms

  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Headache
  • Sleep problems
  • Dizziness when you stand up (lightheadedness)
  • Pins-and-needles feelings
  • Change in smell or taste
  • Depression or anxiety

Digestive symptoms

  • Diarrhea
  • Stomach pain

Other symptoms

  • Joint or muscle pain
  • Rash
  • Changes in menstrual cycles

Some people with post-COVID conditions have symptoms that are not explained by tests and can be hard to manage. Clinical evaluations and results of routine blood tests, chest x-rays, and electrocardiograms may be normal.

The symptoms are similar to those reported by people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and other poorly understood chronic illnesses that may occur after other infections. People with these unexplained symptoms may be misunderstood by their healthcare providers, which can result in a long time for them to get a diagnosis and receive appropriate care or treatment.

Review these tips to help prepare for a healthcare provider appointment for post-COVID conditions.

Health conditions

Some people experience new health conditions after COVID-19 illness.

Some people, especially those who had severe COVID-19, experience multi-organ effects or autoimmune conditions with symptoms lasting weeks, months, or even years after COVID-19 illness. Multi-organ effects can involve many body systems, including the heart, lung, kidney, skin, and brain. As a result of these effects, people who have had COVID-19 may be more likely to develop new health conditions such as diabetes, heart conditions, blood clots, or neurological conditions compared with people who have not had COVID-19.

People experiencing any severe illness may develop health problems. People experiencing any severe illness, hospitalization, or treatment may develop problems such as post-intensive care syndrome (PICS). PICS refers to the health effects that may begin when a person is in an intensive care unit (ICU), and which may persist after a person returns home. These effects can include muscle weakness, problems with thinking and judgment, and symptoms of post- traumatic stress disorder (PTSD), a long-term reaction to a very stressful event. While PICS is not specific to infection with SARS-CoV-2, it may occur and contribute to the person’s experience of post-COVID conditions. For people who experience PICS following a COVID-19 diagnosis, it is difficult to determine whether these health problems are caused by a severe illness, the virus itself, or a combination of both.



Sign up for this program at www.gatewaystotransformation.com or call 303-859-7385 for more information or to sign up.

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