In a hard environment, your gradients will be very noisy — but effectively no more than linear in the duration you are optimizing over, provided that you have a reasonable solution for exploration. As you scale your batch size, you can decrease your variance linearly. So you can use good ol' gradient descent if you can scale up linearly in the hardness of the problem.
This is a handwavy argument admittedly, but seems to match what we are seeing in practice.
Simulators are nice because it is possible to take lots of samples from them — but there's a limit to how many samples can be taken from the real world. In order to decrease the number of samples needed from the environment, we expect that ideas related to model-based RL — where you spend a huge number of neural network flops to learn a model of the environment — will be the way to go. As a community, we are just starting to get fast enough computers to test out ideas there.