I have a relative that was in a trial for some drug for a while. He was taking the drug to begin with, before being asked to participate in the trial.
He knew he had the placebo in the trial because it didn't cut/break in half the same way as the real stuff.
Some of science has become a process of splitting statistical hairs to the degree that the inherently obvious is not allowed for in the construction of studies.
Given a large base of people who have not received the drugs or vaccines already, even with questions about the record keeping, anything which gives patients a significant edge should be readily obvious, improving survival rates by a readily recognizable factor.