The next week, the patient was back in the emergency room with dyspnea. Due to breathing difficulties, we canceled a planned parathyroid (technetium 99 sestamibi) nuclear scan, and surgery was scheduled urgently. The plan for airway management was awake fiberoptic intubation with the smallest reinforced endotracheal tube that would fit over a flexible bronchoscope and was long enough to reach beyond the narrowing of the trachea, which was estimated to be a size six tube. We would not be able to use the larger diameter tubes with electrodes for nerve integrity monitoring. The emergency backup plan for airway management was a cricothyroidotomy to allow placement of a smaller diameter, shorter, pediatric size tube. At this point the pandemic was in its ascendance. Significant questions were raised regarding the risk of infection of the team during emergency airway management. Therefore, given that she was comfortable on room air at rest, the patient was discharged, and surgery was delayed for a few days so that it could be moved to a cardiac bypass operating room which was set up for extracorporeal membrane oxygenation (ECMO). She also was tested and negative for COVID‐19 by nasopharyngeal swab RT‐PCR assay.