The COVID 19 pandemic has spanned 2 years and is still ongoing with many questions arising. We attempt to answer some pertinent questions with literature as well as anecdotal evidence from our facility. To describe any changes to the resuscitation of trauma patients during the COVID 19 pandemic if any. During the COVID 19 pandemic, Johannesburg a city in the Gauteng Province of South Africa experienced civil unrest and a fire at one of its trauma units, this resulted in a mass casualty incident (MCI) at the only functional trauma unit in the public sector. Results of this observational study will be elucidated. Focus is placed on PPE protocols, trauma resuscitations, MCI management, triage principles and the changing surgeon’s role within the pandemic.