We need to do a tracheostomy on a COVID patient," came the call from the ICU; the first thing I heard when I answered. No formalities or niceties exchanged; this was purely medical talk. A tracheostomy is a surgical procedure that involves making a small cut over the neck just below the Adam-s apple, followed by a tiny hole in the windpipe, in order to place a breathing tube. This is performed in patients infected with the Coronavirus, who-ve been connected to a ventilator but are unable to come off it. A tracheostomy bypasses the nasal passage, reducing airway resistance and hence the effort required to breath, enabling a possibly faster weaning off from the ventilator.

This procedure is generally performed by ENT or head and neck surgeons. The ones affiliated with our hospital had certain health and age issues, making it risky for them to work in a COVID-19-infused environment, especially as this is a high-risk aerosol-generating procedure, which has a lofty chance of exposing healthcare workers to the virus. As neurosurgeons, we routinely perform tracheostomies in patients with head injuries who we suspect will need prolonged ventilation; hence, this is part of our training, and a few hundred cases later, expertise.