In a very brief period, the COVID-19 pandemic has swept across the planet leaving governments, societies, and healthcare systems unprepared and under-resourced . New York City now represents the global viral epicenter with roughly one-third of all mortalities in the United States . To date, our hospital has treated thousands of COVID-19 positive patients and sits at the forefront of the United States response to this pandemic . The goal of this paper is to share the lessons learned by our spine division during a crisis when hospital resources and personnel are stretched thin . Such experiences include management of elective and emergent cases, outpatient clinics, physician redeployment, and general health and wellness . As peak infections spread across the United States, we hope this article will serve as a resource for other spine departments on how to manage patient care and healthcare worker deployment during the COVID-19 crisis.