Newborn screening (NBS) is an essential public health program that relies on an entire system to ensure the methodical screening, diagnosis, monitoring, and treatment of babies affected by the screened conditions. As babies are born each day, and timely screening must occur in order to identify at-risk infants before symptoms become apparent, each part of the newborn screening system must maintain functionality even when confronted with unusual and unexpected circumstances. Though the COVID-19 pandemic has placed unfathomable pressure on the newborn screening system, lessons have been learned that must be incorporated into each state’s continuity of operations plan. The utility of one particular resource – telehealth – has been highlighted by the pandemic experience and should be explored and further incorporated throughout the newborn screening system.