Guy’s & St Thomas’ NHS Foundation Trust (GSTT) was one of the first centres in the UK to treat COVID-19 patients, and hence make decisions about tracheostomy. As of 24thApril 2020 there were 171 completed critical care admissions, with a mortality rate of 33%.  A further 104 are currently receiving intensive care for COVID-19 pneumonitis. In March 2020 we developed a dedicated ENT-led tracheostomy team, through close collaboration with intensive care and anaesthetics. Indications for tracheostomy were agreed, intensive training and simulation was undertaken, and our standardised protocol and recommendation is described in detail in our recent publication [7].