The effects of COVID-19 have been acute for individuals, communities and systems around the world, with continuing consequences. At the outset of the pandemic, the potential disruption to planned and ongoing clinical trials was especially concerning; drug development, filings and launches could be affected for years, if not decades. This paper considers the specific role real world approaches can play, both in addressing immediate pandemic issues and in supporting a new, more agile and patient-centric normal for clinical development.