So I got the new Half Life Alyx, and guess what ... my Quest refused to work and the Oculus Desktop application gave the "General Device Problem" error.
After hours of searching, I found a fix that worked on my setup:
I reverted back to an older nVidia driver (441.41) and it works!!!
I completely removed everything nVidia (Experience, all drivers, etc).
Rebooted, and eventually windows installed some old standard driver (v220.127.116.1173 from 2017).
Next I downloaded 441.41 (Nov 2019) from this nVidia drivers page (make your selection, click search and scroll down for older versions).
I presume a regular install will work, I just didn't want all the nVidia stuff installed so I just installed the driver, like so:
After downloading the file, I extracted the downloaded EXE (I used WinRar: right click, extract).
After extracting, I right clicked the display driver in device manager and clicked "Update Driver" and selected "nvtfi.inf" from the "Display.driver" directory (in the extracted directory).
Next I selected my display driver, did get a warning that it may not be compatible (it shows a long list of same named devices - I looked up the specs of mine (GTX 1060 6Gb) and selected the first match. After installing the new driver, I rebooted and ... my Quest Link worked again and Half Life Alyx is awesome!!