Due to the COVID-19 Pandemic our clinic responded early, taking many precautions to keep our patients, staff and society safe with a plan on sustainability. We continued to provide compassionate sustainable pain relief through these tough times. As an anesthesiologist with a medical research background, Dr. Urban made significant changes in the clinic which had evolved with new scientific knowledge. By mid-March 2020, Urban Pain Institute implemented telehealth which has been widely accepted by our patients. With the reduction of COVID-19 risk as people become vaccinated we are continuing telehealth. Frequently we are able to do routine follow-ups and begin some initial patient evaluations via telehealth where patients use their own mobile devices or computers. This has especially benefitted many of our patients in remote areas of Alaska. We are constantly reevaluating the latest medical science. Keep in mind that there is scientific evidence that many of our interventional procedures keep patients away from more invasive surgical procedures and emergency room visit. As some of our patients are not vaccinated and COVID-19 is still present in the community we are still taking some precautions. Following CDC guidelines, in our medical facility, masks are still required. We are also maintaining social distancing and not packing our waiting rooms. Some, but not all, of our interventional procedures utilize corticosteroids. It has been well established that steroids alter an individual’s immune response. As some of our patients are undergoing vaccination for COVID-19, corticosteroids will be appropriately timed so that they can be avoided where they could theoretically suppress an appropriate immune response to the vaccine.