Several time-honored aspects of RCT design including the use of central randomization, preservation of allocation concealment, multi-level study blinding, and use of a matching placebo posed challenges to us in designing a pandemic protocol. We contemplated the necessity of including each of these study design features. After careful deliberation, we decided to include central randomization (using lists distributed by the study methods centre to participating centres), preserve multi-level blinding (by involving pharmacies at participating centres) and contract a local pharmaceutical company to prepare crushed drug and matching placebo (in the absence of industry supply of study drug and an available placebo). Recognizing that trial initiation may be delayed and recruitment curtailed if a priori in-person SDM consent was required, we considered use of alternative consent models. A priori in-person SDM consent not only hinges on the existence and availability of SDMs [39] , but also the ability of SDMs to access hospitals during a pandemic.