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The proverbial saying ‘Necessity is the mother of invention’ is frequently used to explain how great innovations are made during times of urgent need. Never has the need been direr than when the COVID pandemic hit in March 2020 and health care providers were struggling to find treatments for patients fighting this new and deadly disease. It was during this time, ICTS investigator Eric Lenze, MD, the Wallace and Lucille K. Renard Professor of Psychiatry at Washington University School of Medicine, was contemplating research on the pandemic when a colleague suggested an idea to repurpose the drug fluvoxamine as an early treatment for COVID-19. With a depth of experience in clinical trials, Lenze found himself uniquely positioned to implement a fully remote and contactless trial, an innovative study design that became a necessary tactic due to the COVID pandemic’s restrictions on face-to-face contact.