The role of tracheostomy for weaning ventilated patients with COVID-19 pneumonitis remains a matter of debate.  Controversy exists regarding timing, location, prognosis, techniques to reduce aerosol generation, and risk of transmission to healthcare workers.  The mortality rate following admission to critical care with COVID-19 pneumonitis is currently higher than for non-COVID viral pneumonia (50.7% vs 22.0%) as described in the Intensive Care National Audit and Research Centre (ICNARC) report [1].  This must be factored into the decision making process.