Many off-label antiviral and anti-inflammatory drugs are being administered in this first phase of the COVID-19 pandemic. While we do not discourage their use, physicians must be aware that because of the lack of high-level evidence, they may be ethically justifiable only in those worsening patients unlikely to improve with only supportive care and who cannot be enrolled onto RCT. Implementation of well-designed RCT should be expanded as much as possible, as RCTs are the most secure way to change for the better our approach to COVID-19 patients, including our frontline opinions.