There is still no identified viral mechanism for CFS. So yes, you will continue to find many doctors that deny that there is convincing evidence for viral causes of CFS because that is the reality of the current situation.

Fair. I was talking about doctors denying the existence of CFS, but that wasn't the topic, was it?

If I had to make guesses, my take is a viral+immune system interaction. You get the virus which causes your own immune system to respond. In that response we get a 'partial match' to something inside of our own system. This leads to a low level inflammatory attack against your own system.

In type 1 diabetics there is some evidence of a post viral auto-immune cause in some cases.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570378/

And COVID infections increase you risk of developing type 2 diabetes:

https://www.cedars-sinai.org/newsroom/verified-covid-19-infe...

But: absence of evidence is not necessarily evidence of absence. The fact that we still haven't found convincing evidence (with the caveat that 'millions of people complain about certain symptoms in my book counts as overwhelming evidence') doesn't mean that such a mechanism doesn't exist. It may merely mean that we are looking in the wrong places, my not be looking in the right way and in general still have a poor understanding of how our bodies really work.

GBS for instance:

https://www.who.int/news-room/fact-sheets/detail/guillain-ba...

Is linked to post viral or post bacterial infections, and even though here too there is a lack of complete understanding at least the symptoms are so clear (up to complete paralysis) that denying it seems pointless. It's also super rare, so there is no incentive to deny it.

But if COVID ends up putting a sizeable percentage of the workforce out of action that may well have serious implications for how we deal with chronic disease and post viral infections. Incidentally: this is one of the possible futures that various experts warned about during the early days of the pandemic, that it would be a decade or more before we would fully understand the impact and that by assuming the post infection consequences would be mild that we may have made a grave mistake.

Fortunately some of the more outrageous possibilities have so far not surfaced, this is one that we can deal with.

Doctors are not medical forensics. It shouldn't matter that the mechanism behind CFS isn't known, there's ample evidence that the condition is real. So I reject that casual dismissal.

However, there is no known way to treat CFS. That problem is a much more valid excuse for a doctor to do nothing. But a doctor that refuses to acknowledge a patient's troubles because they don't know how to treat it is a bad doctor.

Then agreed it is a problem.

Some investigation revealed though that is has become more difficult for GPs to ignore the pressure put on them by insurers to send patients back to work.