The high-stakes race to find effective COVID-19 treatments

Science · Published 9 October 2026 Swipe more like this →

In short: While vaccines were the initial focus, a massive global effort shifted toward immediate medical interventions. Because developing a vaccine can take years, researchers launched a megatrial to rapidly evaluate multiple treatment options simultaneously for those most vulnerable to severe illness.

In March 2020, the World Health Organization (WHO) initiated a 'megatrial' specifically designed to investigate four different treatment options for COVID-19. This large-scale approach was prompted by the reality that developing an effective vaccine could take at least one year, creating an urgent need for clinical interventions to manage the virus in real-time. This initiative involved a large team of researchers and scientists. The project aimed to provide data on multiple options at once.

Current medical protocols focus on individuals at the highest risk of becoming seriously ill. Eligibility for these treatments is not universal; it is targeted toward people aged 12 or over who have tested positive and possess specific underlying vulnerabilities. These include chromosomal conditions like Down's syndrome, certain cancers, sickle cell disease, chronic kidney disease (stages 4 or 5), severe liver disease, organ transplants, and various autoimmune or inflammatory conditions. Patients with HIV or AIDS who have weakened immune systems also qualify. This group includes those with conditions affecting the brain or nervous system.

The primary antiviral medicines currently utilized in these settings are nirmatrelvir plus ritonavir (Paxlovid) and molnupiravir (Lagevrio). These medications are administered orally as capsules or tablets. The goal of these specific antivirals is to help patients manage symptoms while reducing the overall risk of progressing to severe illness. Doctors determine which specific antiviral is most suitable based on an individual's clinical assessment. These drugs are swallowed rather than injected. A physician will decide which specific medication is best for a patient's needs.

Because treatment availability and logistics vary by region, local integrated care boards and GP surgeries manage the distribution and referral processes. While these antivirals are key for high-risk outpatients, different treatments may be available to those who require hospitalization. Patients can receive an assessment without being admitted to the hospital first. Local organizations are responsible for arranging these specific medical treatments.

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