Over 40, 400 people with COVID-19 have contributed to the PRINCIPLE and PANORAMIC trials; they have helped us test nine COVID treatments and the results have provided badly needed supportive evidence to guide care for millions of people around the world. Finding out what works can be just as important as finding out what does not. For example, in the PRINCIPLE trial, the pre-cursor to PANORAMIC, we found that antibiotics that were commonly used to treat COVID globally did not work and should not be used. This helped reduce unnecessary antibiotic use around the world, reducing this driver of antibiotic resistance.

PRINCIPLE also found that inhaled budesonide, an inhaled steroid used for asthma, helped people recover more quickly from COVID and had a high probability of reducing the need for hospital admission in unvaccinated people. On the other hand, we found that colchicine, an inflammatory drug used for gout, did not speed up recovery.

 In PANORAMIC, while we found that the antiviral drug molnupiravir did not reduce already low hospital admissions when used as an early treatment in the community for COVID-19 by multiply vaccinated people, it did result in earlier time to recovery and sustained early recovery, as well as: reduced severity and duration of all typical COVID symptoms; reduced health care seeking in primary care in some services; reduced viral detection and load, and was well tolerated and safe. We have also produced novel findings about the cost effectiveness of this treatment, and world-first findings about the effect of the drug on viral detection and load.

 PANORAMIC is ongoing and we will soon be publishing groundbreaking results on the effectiveness of another antiviral treatment called Paxlovid.

 Clinical trials must be carried out with the people for whom the treatment is intended for if the results are to be most meaningful. The PRINCIPLE and PANORAMIC trials have made it possible for people to join the studies in all four UK nations, regardless of where they live. Sick people have been able to join the trials without having to leave their homes, which makes it easier and less dangerous for them to join the study. The fore-runner PRINCIPLE and now the PANORAMIC trial represents models of innovation and inclusivity, and exemplify the potential of primary care to lead the way in addressing pressing global health challenges.

We are deeply grateful for all who joined the trial and who gave so generously of their time and shared their experiences of their illness for the benefit of others and to support the NHS.

You are the heroes of applied clinical COVID trials!