The Guardian

Wanderlust and stolen land: how to mindfully explore the American outdoors

Amanda Machado September 18, 2021

Tips for the socially and environmentally responsible traveler.

In her book An Indigenous History of the United States, Roxanne Dunbar-Ortiz argues the US romanticizes outdoor travel to hide its colonial roots. Many Americans were raised on the belief that our heritage was wanderlust. Chasing “wilderness” was our right. But lost in this lore is the acknowledgment that our national park system was built upon stolen land.

As a travel writer, I believe deeply in our human nature to explore. But historically, the way we take advantage of our national parks has often caused harm: the genocide of Indigenous communities to make “space” for outdoor recreation, the unmanageable waste that accumulates from large crowds of tourists, the scarcity of resources for people living near parks.

The global spread of Covid-19 and the acceleration of climate change present even more ethical concerns: how do we balance our impulse to explore new horizons while also acknowledging the harm it may cause?

For tourists seeking to travel ethically to US national parks, here are tips to consider before planning your visit.

Research how the pandemic has affected local communities surrounding national parks

Many travelers faced criticism last year for recklessly visiting locations overwhelmed by Covid-19. This pattern of urban elites descending upon rural communities led to what Michigan State University professor Jean Hardy calls “disaster gentrification”: While outdoor destinations are presented as a place of “escape”, an influx of visitors may compound crises for local communities.

In Navajo Nation, parks remained closed due to Covid for far longer than others across the country. Kelkiyana Yazzie, an employee at Navajo National Monument in northern Arizona, says outside travelers often responded to closures and mask mandates with confusion and resentment without understanding how tribal communities were particularly hard hit.

“They’d make comments like, ‘I don’t understand why you are closed, you are out in the middle of nowhere, the virus can’t reach you there,’” Yazzie said. Last November, Yazzie lost seven family members to the virus over the course of two weeks, and knew many families on the reservation who had a similar experience to her own.

Travelers must be mindful of the unique strains caused by the pandemic – and adjust expectations accordingly. Recreate Responsibly, a network of outdoor leaders who compile resources on ethical travel, has an online toolkit on how to plan for park visits while also navigating Covid concerns.

“Your relationship to a national park starts before you show up at the trailhead,” says Eugenie Bostrom, a leader behind the group. “It begins with your understanding of every way you impact your surroundings.”

Consider alternatives to popular tourist destinations

Tourism at national parks has escalated dramatically in recent years, leading to overcrowding at popular attractions. In 2016 and 2017, national parks experienced the highest number of visitors ever recorded. The Disneyfication of national parks like Zion, Yosemite, Yellowstone and others created a new phenomena of visitors “loving our national parks to death.”

No matter how responsible any outdoor enthusiast strives to be, Bostrom admits “the land use is surpassing the ability to maintain the land itself.” When Bostrom spoke to leaders in the National Park Service, they said the best path forward is to “spread the love.”

“The federal government manages over 600 million acres of land across the United States. But only 80 million acres are national parks,” Bostrom said. “There are so many other options with the capacity to receive more visitors.”

Folks who crave hikes among the dramatic red canyons at Zion can instead visit other parts of Utah. The majestic alpine landscape of Yosemite can also be found in nearby national forests around California. Most federal land and national forests across the US allow dispersed camping, where travelers don’t have to book reservations in advance or pay money.

Seek out opportunities to acknowledge Indigenous communities

Before I begin any hike, I use a practice I learned from Indigenous environmentalists like Pinar Sinopoulos-Lloyd and Robin Kimmerer: introduce myself to land. This practice reframes outdoor recreation from an act that exploits land for our own benefit to a means of building a relationship with land by naming our intentions and expressing gratitude.

The practice can also include learning about the native communities who previously stewarded the land. At the beginning of your hiking or camping adventure, take a few minutes to ask yourself: what is this land’s racial and colonial history? What actions can we take now to repair the harm already caused?

Action guides can also help travelers contribute to Indigenous-led land trusts and other environmental projects that return the autonomy of stewarding land back to Indigenous leaders. (Indigenous communities control only about 2% of land in the United States.)

Travelers can also factor in this financial contribution as a “land tax” or “land reparations” payment in their national park vacation budget.

Explore ways to abandon the mindset of chasing after ‘pristine wilderness’

After years on the road, I became more aware of how my own travels reinforced a colonial idea: if I searched long and far enough, I could find my own version of “untouched paradise”. We focus so hard on “leave no trace” while visiting a park, but then come home to our city lifestyles of hyperconsumption that ultimately leave a huge trace on the environment.

Now when I plan a trip, I remind myself that no stunning landscape can distract from the impact we have as humans on land every day – in and outside the parks.

Vasu Sojitra, a professional outdoor athlete, believes this is the core problem: the false binary we’ve created between “protected land” and the land we inhabit day-to-day.

“We’re always a part of nature,” Sojitra said. “Once we learn to be in a symbiotic relationship with land, we won’t need national parks, or ‘leave no trace’ principles, or even need to talk about ethical travel at all, because we’ll already be living with that mindfulness and consciousness in everything we do.”

• This article was amended on 22 September 2021 to correct the name of Recreate Responsibly.

Reuters

U.S. Treasury climate official seeks insurance changes for extreme weather

Andrea Shalal and David Lawder September 9, 2021

Remnanents of Ida are seen in New York

WASHINGTON (Reuters) – Climate-related weather events are costing American households, businesses and insurers billions of dollars in losses, and there is no sign that they will ease up, the U.S. Treasury’s top climate official told Reuters on Thursday.

Climate counselor John Morton said Treasury’s Federal Insurance Office (FIO) /federal-insurance-office-request-for-information-on-the-insurance-sector-and-climate-related was seeking public input to better understand and assess the insurance-related risks posed by climate-related weather events such Hurricane Ida.

Hurricane Ida, which made landfall on Aug. 29 with 150 mile-per-hour (240 kph) winds, cutting most U.S. offshore oil and gas production for more than a week and damaging platforms and onshore support facilities. It was among the most costly hurricanes since back-to-back storms in 2005 cut output for months, according to the latest data and historical records.

“Just last year, climate-related weather events resulted in nearly $120 billion in losses, and … close to $50 billion of that were uninsured losses,” Morton said in an interview.

“We’re seeing not only the insurance sector take an increasingly severe and regular hit, but we’re seeing American households, American small businesses be affected at significant levels,” he said. “And there’s no reason to expect those losses are going to stop.”

The Federal Insurance Office will accept input for 75 days and then come up with recommendations for better pricing the risks that climate change posed to insured properties and activities, Morton said.

“The question is, how do we … better understand and begin to price the risk inherent in the underlying activities,” he said.

In its Aug. 31 request for information, it cited a dramatic increase in the frequency and severity of climate-related disasters, and said they had resulted in growing economic losses and financial risk.

“The increased frequency and severity of climate-related disasters, as well as the magnitude of associated insured losses, highlight the significance of these climate-related financial risks and the role of insurers in responding to them,” it said, adding that some consumers are increasingly unable to find affordable property insurance in certain markets.

(Reporting by Andrea Shalal and David Lawder; additional reporting by Trevor Hunnicutt)

Yahoo ! Money

Retirement expert: Start thinking about climate change in your golden years

Stephanie Asymkos, Reporter September 10, 2021

Extreme weather conditions brought on by climate change should cause some Americans to rethink their retirement destinations, according to one expert.

“Most people want to escape the winters of the Northeast or the high taxes of certain states, but [climate change] may make them pause and do a little bit more research,” James Ciprich, certified financial planner and wealth advisor with RegentAtlantic Capital, told Yahoo Money. “Proximity to health care and low taxes are always attractive options, but now especially for seniors, you almost need to be thinking in terms of what is my contingency plan in the event of a weather disaster.”

No longer relegated to Tornado Alley or California’s brush country, the effects of climate change can be seen across the United States. Just last month, New York City saw a record rainfall a week after setting the previous high, while earlier this summer residents of the Pacific Northwest sought in-home air-conditioning units — long rare for the region —as temperatures reached record-breaking triple-digit highs. This past winter, central Texas experienced a deep freeze that shut down its power grid.

For those set on relocating or staying put for their golden years, they will likely have to contend with wild weather and safeguarding their homes, which means nest eggs will be spread even thinner for inflated utility bills, possible home repairs from natural disasters, and ongoing expenses like insurance, Ciprich said.

Disaster planning could be the antithesis of relaxation and leisure, but emergency scenarios may become bigger and more common disruptions as people age. Ciprich added that evacuations could become more difficult as mobility typically declines later in life and shelters might not be able to accommodate people who require intensive care.

Swapping high taxes for costly home insurance or the need for year-round cooling could offset the cost of any savings achieved from relocation.

What surprises Ciprich’s clients, the majority of which come from the New York metropolitan area, is how little they actually save when they move to lower-cost states because what’s saved in property taxes is spent in other areas like homeowners insurance.

Connecticut, New Jersey, and New York residents pay among the highest property taxes in the country, but New Jerseyans pay an average of $751 per year in homeowners insurance, which is 43% below the national average of $1,312 for a $250,000 home. For comparison, Floridians pay $1,353 per year for a home of the same value, according to Bankrate, to account for its geographic predisposition and frequency of natural disasters like storms, hurricanes, and flooding.

While residents in Hurricane Alley states like Florida, South Carolina, and Texas have some of the country’s cheapest flood insurance — all under the U.S. average of $958 — a larger share of homeowners require this coverage versus more costly states. In Vermont, which has the highest average flood insurance cost, only 1.76% of households there carry it.

The expenses don’t stop at insurance. There’s a cost associated with attempting to protect your home and valuables from natural disasters.

Hurricane preparedness provisions like plywood, nails, and sandbags are pricey one-off expenses, but permanent fixtures like home power generators run as much as $7,750. A 10-square-foot prefabricated tornado safe room could set you back $3,000 plus installation. Hurricane shutters range from $2,000 to $5,750, and a seismic retrofit to protect against earthquake damage may cost between $3,000 and $7,000.

Ciprich suggests evaluating the changing weather patterns even when there are no plans to relocate but emphasized the “need to take a close look at the destination and what issues they have” rather than trading one threat for another.

So where to go?

Some soon-to-be retirees actively plan to mitigate the risks of hurricanes, droughts, and wildfires, while the threat is a non-starter for others. After all, The Villages, Central Florida’s sprawling retirement community, was the country’s fastest-growing metro area of the last decade despite concerns the state could experience harsher hurricanes.

In general, when entertaining the thought of relocating to a new location for your golden years, Ciprich recommends a “retirement destination test drive” to determine if it meets your expectations before stakes are firmly planted in the ground.

“Maybe rent in the area for a year so you can go through all of the seasons,” he said. “After that, you might come to the conclusion that it wasn’t really so bad or you change your mind.”

The Santa Fe New Mexican

New Mexico cattle ranchers pummeled by ongoing drought

Time

How ‘America’s Frontline Doctors’ Sold Access to Bogus COVID-19 Treatments—and Left Patients in the Lurch

By Vera Bergengruen   August 26, 2021

Tablets of Ivermectin on May 19, 2021. Soumyabrata Roy—NurPhoto/Shutterstock

Mike says he was struggling with COVID-19 when he felt his breathing getting worse. He did not want to go to the Veterans Affairs hospital near his home, where he believed doctors might put him on a ventilator. And he knew they would not prescribe the treatment he really wanted: a drug called ivermectin.

So in late July, Mike, who says he is a 48-year-old teacher and disabled veteran from New York state, contacted America’s Frontline Doctors (AFLD), a group he had been following on social media. AFLD has been a leading promoter of ivermectin, a medication typically used to treat parasitic worms in livestock, as a “safe and effective treatment” for COVID-19. Through its website, Mike says, he paid the group $90 for a telemedicine appointment with a doctor willing to prescribe the drug.

A week later, he was still anxiously waiting for the consultation. Calls and emails to AFLD went unreturned, he says. Finally, he called his bank to report a fraudulent charge. “Not even an apology,” Mike, whom TIME is referring to using a pseudonym because of his concerns about his job, told TIME in an interview. “This is absolutely nuts. This organization is not helping anyone but their pocketbooks.”

---

Similar stories have flooded anti-vaccine forums and messaging apps in recent weeks as some customers and donors raise doubts about AFLD. The group describes itself as a “non-partisan” group of medical professionals. But it originated as a right-wing political organization, and since its founding has consistently spread medical misinformation. Its name implies the group consists of physicians on the frontlines of the pandemic, but it’s not clear how many of its members have spent any time treating patients with COVID-19.

Its followers aren’t the only ones with questions about AFLD. It’s hard to pin down how many people the group employs, how much money it’s taking in, or how that money has been spent, in part because the non-profit has failed to file required disclosures. After it failed to submit its annual report in Arizona, where the group is registered under the name “Free Speech Foundation,” the state recently downgraded the organization’s charitable status to “pending inactive.”

Over the past three months, a TIME investigation found, hundreds of AFLD customers and donors have accused the group of touting a service promising prescriptions for ivermectin, which medical authorities say should not be taken to treat or prevent COVID-19, and failing to deliver after a fee had been paid. Some customers described being charged for consultations that did not happen. Others said they were connected to digital pharmacies that quoted excessive prices of up to $700 for the cheap medication. In more than 3,000 messages reviewed by TIME, dozens of people described their or their family members’ COVID-19 symptoms worsening while they waited for an unproven “wonder drug” that didn’t arrive.

“My mom has now been admitted to the hospital with Covid,” one user wrote Aug. 12 on the group’s channel on the messaging app Telegram. “AFLDS has not returned a call or message to her and they’ve taken over $500 out of her account!”

Since its founding last year by Dr. Simone Gold, a Los Angeles physician who was later arrested during the Jan. 6 attack on the U.S. Capitol, America’s Frontline Doctors has nurtured medical conspiracies popular in right-wing circles. Created as a political project to support the Trump Administration’s economic reopening push, it ricocheted from promoting skepticism about COVID-19 to launching a national RV tour to denounce “medical censorship and cancel culture.” It promoted hydroxychloroquine as a miracle drug and billed itself as a provider of legal services for people who refuse to be vaccinated or to wear a mask, or who want to stop vaccinations for children.

The group’s profile has soared amid the rise of employer-imposed COVID-19 mandates and the emergence of ivermectin as an alternative treatment of choice for the broader anti-vaccine community. AFLD’s Telegram channels have rapidly grown to more than 160,000 users. Its website traffic has quadrupled since April, according to an analysis by the web-analytics company SemRush, which estimates it drew nearly half a million visitors in July. In the process, AFLD’s reach has spread beyond to mainstream sites like Instagram and TikTok, making it a leading purveyor of medical disinformation that erodes public confidence and hinders efforts to get the pandemic under control, experts say.

“They’re the 21st century, digital version of snake-oil salesmen,” says Irwin Redlener, a physician who directs the National Center for Disaster Preparedness at Columbia University. “And in the case of ivermectin, it’s extremely dangerous.”

America’s Frontline Doctors declined repeated requests for comment on this story. On its Telegram channels, moderators have blamed user error and overwhelming demand for the ivermectin delays and promised refunds for customers who fail to receive the consultations with doctors that they paid for. Attempts to reach Dr. Gold, the group’s founder, through her lawyer were unsuccessful.

Federal authorities are cracking down on coronavirus-related telemedicine schemes. The Federal Trade Commission has sent nearly 400 warning letters to groups and individuals marketing false COVID-19 treatments, including one missive, in April, telling a Texas medical practice to “immediately cease” promoting ivermectin or face steep fines. It is illegal under the federal COVID-19 Consumer Protection Act, enacted earlier this year, to advertise that a product can prevent, treat or cure COVID-19 “unless you possess competent and reliable scientific evidence substantiating that the claims are true.” No such study exists for ivermectin, according to the FDA.

Yet despite the FDA’s warnings about the dangers of misusing ivermectin to treat or prevent COVID-19, the drug has become highly sought after in anti-vaccine circles. Doctors and pharmacists tell TIME they have noticed a surge in ivermectin prescriptions called in by telemedicine services, and a growing number of patients demanding it as an alternative to COVID-19 vaccines. Many who fail to obtain prescriptions through groups like AFLD or find it too expensive have resorted to buying an alternative from feed stores that is designed for use in livestock, according to Telegram chats, which reveal members advising each other on proper dosages. Mississippi health officials said Aug. 20 that 70% of recent calls to its poison control center were from people ingesting ivermectin meant for livestock.A nurse checks on a patient in the ICU Covid-19 ward at NEA Baptist Memorial Hospital in Jonesboro, Ark., on Aug. 4, 2021. Houston Cofield—Bloomberg/Getty Images

The ivermectin craze reflects some of the most damaging elements of the post-Trump conservative movement, with a mixture of political profiteering, disinformation, exploitation of social media and conspiratorial thinking combining at a critical point in the pandemic. AFLD has capitalized on “the perfect storm of everything that you needed to have a large population of people susceptible to vaccine misinformation,” says Kolina Koltai, a researcher who studies the anti-vaccine movement at the University of Washington. “America’s Frontline Doctors are really good at what they do. This idea of doctors fighting the system is a narrative that is really appealing to a lot of people.”

‘A coordinated political effort’

On July 27, 2020, a small group of doctors assembled on the steps of the Supreme Court for a news conference. At the time, President Donald Trump was pushing for governors to reopen their states and conservatives had grown increasingly frustrated with lockdown measures. The physicians, who wore white lab coats embroidered with the AFLD logo, had come to repeat a range of White House talking points. They claimed the mental toll of the lockdowns was worse than the virus itself, that hydroxychloroquine was an effective treatment for COVID-19 and that masks weren’t necessary—all of which had been contradicted by U.S. health officials.

To the extent that the mainstream medical community paid attention to the group at all, it was to point out that these doctors making misstatements lacked the expertise to comment. There was no evidence that any of the doctors who spoke that day had treated patients severely ill with the virus, according to MedPage Today, a peer-reviewed medical news site. None of them were infectious-disease experts or worked in intensive-care units during the pandemic. One was best known for promoting bizarre religious beliefs, including tweeting that America needed “deliverance from demon sperm” because people were falling ill from having sex with demons and witches in their dreams. Two of the “frontline” doctors were ophthalmologists, only one of whom was still licensed.

The emergence of AFLD was a coordinated political effort months in the making. The group was the brainchild of the Council for National Policy (CNP), a secretive network of conservative activists. During a May 11 call of CNP members that was leaked to the Center for Media and Democracy, a progressive watchdog group, members complained that Trump was being slammed for his handling of the pandemic, including failing to follow scientific guidelines. The group needed their own medical professionals to promote their message, they said, in the face of data showing two-thirds of Americans were wary of restarting the economy.

“There is a coalition of doctors who are extremely pro-Trump, that have been preparing and coming together for the war ahead in the campaign on health care,” Nancy Schulze, a Republican activist married to a former Pennsylvania congressman, said on the call. “And these doctors could be activated for this conversation now.”

Eight days later, conservative groups publicized a letter signed by more than 500 doctors calling the lockdowns a “mass casualty event.” The lead signatory was Dr. Simone Gold, a licensed emergency-room physician and Stanford-educated lawyer who was working as a part-time, independent contractor in a hospital in Bakersfield, Calif. Ten weeks after the letter’s release, Gold was standing on the steps of the Supreme Court as the founder of AFLD as Rep. Ralph Norman, a South Carolina Republican, thanked the white-coated physicians for coming to “tell us the truth.” The event was hosted and funded by the Tea Party Patriots, a pro-Trump right-wing group.

While few people attended the event, a video of the press conference went viral after it was retweeted by Trump, earning some members of the group an audience with Vice President Mike Pence. And though it was subsequently removed by social-media platforms for spreading misinformation, Gold and other members made the rounds on conservative media, from Fox News to Alex Jones and Pat Robertson.

Since then, the group has positioned itself as the leading alternative medical source for COVID-19 skeptics. Its message has changed to match the moment. At first, Gold downplayed the severity of the virus. “We’re all acting as though there’s a huge medical crisis,” she said in a May 2020 video, as the number of Americans dead from COVID-19 passed 100,000. “I’m not sure that it’s front-page news.” The real issue, Gold added, was that “our constitutional rights are being trampled on right and left.”

Soon after, the group argued there was a conspiracy to suppress an effective treatment for the pandemic ravaging the globe. “If all Americans had access to hydroxychloroquine, the pandemic would essentially end in about 30 days,” another member of AFLD, a child psychiatrist named Mark McDonald, said on a video picked up by Alex Jones’ NewsWars website. The group soon partnered with a telemedicine site set up by right-wing conspiracy theorist Jerome Corsi to sell prescriptions for the medication, which Trump promoted and said he took as a preventive measure.

As it turned out, promoting fictions about COVID-19 could be profitable. AFLD built a slick website, whose domain was bought by the Tea Party Patriots, and an email list of loyal followers whom they urged to make donations. When Gold was arrested for participating in the Jan. 6 insurrection, emails to supporters requesting their “urgent and generous donations to withstand such aggressive assaults from the ruthless enemies of free speech” raised more than $400,000 for Gold’s legal defense.

In the spring of 2021, the group announced a national RV tour, which sold VIP tickets for a “meet-and-greet” with Gold for $1,000. According to AFLD Telegram channels, they frequently canceled scheduled appearances, leaving people who had taken the day off work or driven for hours in the lurch. “Hundreds of us registered and received no information or cancellation notice,” one disappointed supporter in Cleveland wrote on June 22 when the promised tour did not arrive. AFLD moderators, meanwhile, urged followers that such events could “continue only when everyone donates what they can monthly.”

By then, the group had pivoted from hydroxychloroquine and medical choice to anti-vaccine content. AFLD falsely claimed the Covid-19 vaccines were “not effective in treating or preventing” the virus and that they had killed 45,000 people in the U.S. “This is an experimental biological agent whose harms are well documented,” Gold said in a statement on the group’s website in May. The group compared lockdown measures to Communist tactics of the 1950s and urged supporters to call their lawmakers to demand they introduce a “Vaccine Bill of Rights”—versions of which soon cropped up in Wyoming, Kansas, Missouri, Minnesota and South Carolina, including boilerplate written by AFLD.

Then, as the Delta variant tore across the U.S. and people in AFLDs forums started to report themselves or their family members falling ill, the group started heavily promoting ivermectin.

‘I feel scammed.’

Ivermectin first gained prominence in December 2020, when Dr. Pierre Kory, then a pulmonary care specialist at a Wisconsin hospital, testified about the “wonder drug” to a Senate panel chaired by Wisconsin Sen. Ron Johnson, a Trump ally known has touted alternative treatments to COVID-19.Dr. Pierre Kory testifies during the Senate Homeland Security and Governmental Affairs Committee hearing titled Early Outpatient Treatment: An Essential Part of a COVID-19 Solution, Part II, in Dirksen Building on Dec. 8, 2020. Tom Williams—CQ-Roll Call/Getty Images

The anti-parasite drug, which is commonly used for horses, is approved to treat certain parasitic worms in humans. It is not an antiviral medication and there is no evidence that it is effective in preventing or treating Covid-19, according to the FDA, which says overdoses of the drug can lead to vomiting, allergic reactions, seizures, coma, and even death.

Two pharmacists told TIME said they were alarmed when they noticed an odd surge in ivermectin prescriptions called in by telemedicine doctors in recent weeks. “We’re calling it the second coming of hydroxychloroquine,” one pharmacist in Maine says, noting he had seen prescriptions come in from “quack telehealth prescribers” in Texas, Florida, Illinois and California. “It’s wild to me and other pharmacists I’ve talked to how people won’t get a vaccine that is well-tolerated and effective because it’s ‘experimental’ but they’ll take a dose of ivermectin that’s been extrapolated based on weight from equine veterinary guidelines.”

On social media, AFLD is one of the top organizations steering customers to the de-worming medication as a coronavirus treatment. On its website, people looking for “Covid-19 medicine” are told to click on a button labeled “Contact a physician” and pay $90 for a consultation. The link takes customers to another website, “Speak With An MD,” where they’re asked to submit payment information and told that one of the “frontline doctors” will call them within a few days, with sick patients being prioritized. The group describes “Speak with an MD” as a “telemedicine service with hundreds of AFLDS-trained physicians.”

But the actual service is Encore Telemedicine, a company that connects patients to teledoctors willing to write prescriptions, according to the web portal and posts by AFLD staffers. Since 2015, it appears to have been run out of a home by a golf club in suburban Georgia, according to its business registration. (Encore’s CEO did not respond to requests for comment.)

The orders made through Encore Telemedicine then go to Ravkoo, a digital pharmacy in Auburndale, Florida, whose address listed online appears to be a dilapidated white structure by a strip mall. Ravkoo is supposed to either mail the medicine or call it into a local pharmacy. (The owner of Ravkoo did not respond to requests for comment). The cost of the medicine is applied on top of the consultation fee, and varies widely, from $70 to $700, according to AFLD customers’ comments.

It’s not clear how much America’s Frontline Doctors gets from each patient referral. The service is marketed on AFLD’s site for $90, while a direct telemedicine consultation through Speak With An MD is listed at just $59.99, a $30 difference. AFLD declined to comment on whether they receive any financial benefit from the referral.

AFLD has been using this system to sell hydroxychloroquine since at least last fall. But the network has been overwhelmed by a surge in demand for ivermectin in recent weeks, according to frustrated customers.

The group’s chaotic Telegram channels are filled with questions. Some say they paid for a consultation but never received a call from a doctor. Others say they were prescribed ivermectin but never received it; still others received the wrong medications or were charged inflated prices. Customers claimed to have paid for the non-refundable consultation and the drugs, only to have their local pharmacies refuse to fill the prescription because ivermectin is not approved to treat COVID-19. All of these people reported that repeated calls and emails sent to AFLD, Encore Telemedicine and Ravkoo went unanswered.

Many users call the arrangement a fraud. “Still no drugs as prescribed! Have not heard from their pharmacy. Very disappointing,” one user wrote on Telegram Aug. 1. “They took my money though. Definitely feels like a scam.” That same day, another frustrated customer wrote: “You tell us the vaccine producers are getting rich off us. Seems like you are doing very well yourselves?”

Another user told TIME she paid the $90 and never got the doctor consultation, but did get a call from a pharmacy that charged her another $100. “I have not heard a word. I feel scammed,” says the user, who would provide only her first name, Denise.

Other supporters, who had been promised they’d speak to “AFLDs-trained physicians,” were upset when the doctor pressed them to get the vaccine during the paid phone consultation. “Not happy at all with that!” wrote one woman who said her daughter’s telemedicine doctor had told her to get vaccinated in addition to prescribing ivermectin. “I felt like I could trust them not to push the vaccine…severely disappointed.”

Dozens of messages reviewed by TIME were from people with sick family members, who were begging for AFLDs to escalate their cases. A woman named Chynthia who had paid the fee—“$90 is a lot for us,” she said—wrote that she had never been called back. “Please help! My husband is sick. And looks like he does have a hard time breathing.”

As the confusion has mounted, some have questioned the group’s motives. A user named Vinod told TIME he had been a monthly donor to AFLD but had to call his credit-card company to stop repeated fraudulent charges and ask for a replacement card to prevent other fees from piling up.

Moderators for the AFLDs group on Telegram acknowledged to frustrated users that they were overwhelmed by the demand, although they said to “blame the CDC for the blockade” of ivermectin. But they insisted that once the physician fee is paid, “this is out of AFLDs hands operationally because of HIPPA [sic].”

‘The anti-vax movement as a whole is one big multi-level marketing scheme.’

The embrace of ivermectin by the broader anti-vaccine community has expanded AFLD’s reach. On TikTok, more than a dozen accounts reviewed by TIME show young people, some of them teenagers, touting ivermectin as a COVID-19 cure and promoting AFLD as the place to buy it. “It’s done wonders for me and it’s kicked Covid’s ass,” said one young user who documented her recovery over six videos, using the hashtag #novaccine and recommending others get ivermectin through AFLD.

Dr. Siyab Panhwar, a cardiology fellow at the University of Tulane, has been using his own TikTok account to refute misinformation about ivermectin. “The unfortunate reality is that there are some doctors that push this, and it harms the entire community,” says Dr. Panhwar. “[AFLD] say on their website that they will ‘review your history’ but I call B.S. There is no physical examination…How is this medically appropriate or safe? AFLD is dangerous and needs to be stopped.” The financial incentive to push products like ivermectin should be a massive red flag, Panhwar says. “The anti-vax movement as a whole is one big multi-level marketing scheme.”Protesters against COVID-19 vaccine and mask mandates demonstrate near the state Capitol in Santa Fe, N.M. on Aug. 20, 2021. Cedar Attanasio—AP

None of this is slowing AFLD’s movement. As fights over vaccine mandates and school-masking policies ramp up, AFLD has created “Citizen Corps” chapters in almost every state, with dedicated Telegrams channels and public events, like a Texas meeting that drew 80 people to hear lectures about vaccine side effects. At the group’s “White Coat Summit” in July to commemorate its first anniversary, it cut a video of children ceremonially burning their masks while singing “We Are The World.”

AFLD has meanwhile garnered significant publicity by touting itself as a legal resource for people who want to defy employers’ mandates to be vaccinated, tested or wear a mask. AFLD has used its “legal eagle dream team” to solicit funds, but according to some donors, that promised help has also failed to materialize. “Still waiting to hear back from legal eagle,” a user named Carlos, who said he had submitted multiple forms and emails for legal help, said on Telegram on Aug. 14. “I’m about to get fired and need legal help.”

Several supporters said they were defying employer vaccine mandates based on information and advice from AFLD. “I hope you guys are right,” a user named Jeffery posted on Aug. 20 in response to a video from the group promising to fight vaccine mandates in court. “I’m about to lose my career of over 20 years, my pension and my livelihood because I’m not taking the shot.” Others say their employers laughed off the vaccine-exemption forms they’ve printed off the AFLD website. “I am losing hope,” wrote one user named Cathy on July 6. “I just spoke with a lawyer that said the proof from Frontline Doctors is a conspiracy theory.”

The pleas of customers who trusted the group have often grown desperate. “Does anyone know how long it takes to hear back from America’s Frontline Doctors about getting Covid medicine?” asked a user who said she was pregnant and having chest pain and shortness of breath from the virus. “It seems like I’ll never hear back from them in my worst moment of need.”

On Aug. 17, one man posted in the group’s Telegram that he had waited on AFLD for weeks before they canceled his consultation for ivermectin. “Wish they hadn’t because my wife is in the ICU now,” he wrote. “Had I gotten the meds she would have been fine.”

With reporting by Alejandro de la Garza, Simmone Shah and Julia Zorthian

Miami Herald

Tropical Depression 12 forms in far east Atlantic. It could be Hurricane Larry by Friday

MSNBC – Opinion

Trump’s lawyers used his tactics to spread disinfo. Now they’re paying for it.

By Barbara McQuade, MSNBC Opinion Columnist   August 27, 2021

The pro-Trump lawyers may still have succeeded in giving Trump and his allies the talking points they need to perpetuate the big lie.

Truth has taken a beating during the past few years, from former President Donald Trump’s claims about the size of the crowd at his inauguration to his statements that Covid-19 was a hoax. But on Wednesday, U.S. District Judge Linda V. Parker, in Detroit, took a strong stand in its defense when she issued an order imposing sanctions against lawyers aligned with former President Donald Trump for what she called “a historic and profound abuse of the judicial process.”

The lawyers sought a preliminary injunction to decertify the election results and to certify Trump as the winner instead.

Shortly after the November election, attorneys Sidney Powell, Lin Wood and others filed a lawsuit on behalf of Michigan voters against state officials alleging a scheme to “illegally manipulate the vote count” in favor of President Joe Biden, who won the election in Michigan by around 150,000 votes.

The lawyers sought a preliminary injunction to decertify the election results and to certify Trump as the winner instead. In December, Judge Parker denied the injunction request, finding that the plaintiffs were unlikely to succeed on the merits, and noting that the claims were based on nothing more than “theories, conjecture and speculation.”

In July, Parker held a roughly six-hour hearing, in which Trump’s lawyers had few answers to her questions about the absence of a factual basis for their allegations. In a 110-page opinion, Parker took the rare step of punishing the lawyers for their abuse of the court system. Finding that the lawsuit had been filed “in bad faith and for an improper purpose,” she ordered the lawyers to pay the legal fees incurred by taxpayers of the state of Michigan and the city of Detroit.

She also ordered the lawyers to complete 12 of hours of legal education on pleading standards and election law. And she directed the clerk to send her opinion to the disciplinary authorities in the jurisdictions where each lawyer is licensed to consider suspension or disbarment.

Parker cited the need to deter others from engaging in similar behavior, which she characterized as “deceiving a federal court and the American people into believing that rights were infringed, without regard to whether any laws or rights were in fact violated.”

Lawyers have a legal and ethical duty to avoid filing lawsuits that are frivolous. But calling this lawsuit frivolous is to understate its harm. The term “frivolous” suggests a lack of legal merit. What happened here was far more sinister.

Calling this lawsuit frivolous is to understate its harm.

These lawyers most certainly were aware they lacked the evidence to win this lawsuit. And yet they filed it anyway because it advanced an affirmative disinformation campaign designed to convince the public that the election had been stolen. As Parker wrote, “This case was never about fraud—it was about undermining the People’s faith in our democracy and debasing the judicial process to do so.”

Filing a lawsuit without any factual basis sounds a lot like the strategy that a book by two Washington Post reporters said another Trump lawyer, Rudy Giuliani, articulated on election night in November: “Just say we won.”

Trump himself apparently repeated a version of this mantra in a December phone conversation with acting Attorney General Jeffrey Rosen. After Rosen rebuffed Trump’s requests to investigate election fraud, The Washington Post reported, he pressured him to “just say the election was corrupt, and leave the rest to me.” In fact, according to Gordon Sondland, the former ambassador to the European Union, Trump used a similar tactic with the president of Ukraine. In exchange for military aid and a White House meeting, Volodymyr Zelenskyy did not actually have to conduct an investigation of Biden, Sondland testified — he just had to announce one.

Similarly, Powell and her colleagues did not need to win their lawsuits in Michigan and elsewhere; they just needed to file them to give Trump and his allies the talking points they needed to perpetuate the big lie. Parker wrote, “Many people have latched on to this narrative, citing as proof counsel’s submissions in this case.”

In imposing sanctions, Parker called out the lawyers who are willing to kill truth to advance a political agenda. Sanctions, she wrote, were necessary in this case to deter “future frivolous lawsuits designed primarily to spread the narrative that our election processes are rigged and our democratic institutions cannot be trusted.”

Only by exposing disinformation tactics can we begin to recognize them and build resilience to them as an electorate.

TIME

How ‘America’s Frontline Doctors’ Sold Access to Bogus COVID-19 Treatments—and Left Patients in the Lurch

Vera Bergengruen – August 26, 2021

Tablets of Ivermectin on May 19, 2021. Soumyabrata Roy—NurPhoto/Shutterstock

Mike says he was struggling with COVID-19 when he felt his breathing getting worse. He did not want to go to the Veterans Affairs hospital near his home, where he believed doctors might put him on a ventilator. And he knew they would not prescribe the treatment he really wanted: a drug called ivermectin.

So in late July, Mike, who says he is a 48-year-old teacher and disabled veteran from New York state, contacted America’s Frontline Doctors (AFLD), a group he had been following on social media. AFLD has been a leading promoter of ivermectin, a medication typically used to treat parasitic worms in livestock, as a “safe and effective treatment” for COVID-19. Through its website, Mike says, he paid the group $90 for a telemedicine appointment with a doctor willing to prescribe the drug.

A week later, he was still anxiously waiting for the consultation. Calls and emails to AFLD went unreturned, he says. Finally, he called his bank to report a fraudulent charge. “Not even an apology,” Mike, whom TIME is referring to using a pseudonym because of his concerns about his job, told TIME in an interview. “This is absolutely nuts. This organization is not helping anyone but their pocketbooks.”

---

Similar stories have flooded anti-vaccine forums and messaging apps in recent weeks as some customers and donors raise doubts about AFLD. The group describes itself as a “non-partisan” group of medical professionals. But it originated as a right-wing political organization, and since its founding has consistently spread medical misinformation. Its name implies the group consists of physicians on the frontlines of the pandemic, but it’s not clear how many of its members have spent any time treating patients with COVID-19.

Its followers aren’t the only ones with questions about AFLD. It’s hard to pin down how many people the group employs, how much money it’s taking in, or how that money has been spent, in part because the non-profit has failed to file required disclosures. After it failed to submit its annual report in Arizona, where the group is registered under the name “Free Speech Foundation,” the state recently downgraded the organization’s charitable status to “pending inactive.”

Over the past three months, a TIME investigation found, hundreds of AFLD customers and donors have accused the group of touting a service promising prescriptions for ivermectin, which medical authorities say should not be taken to treat or prevent COVID-19, and failing to deliver after a fee had been paid. Some customers described being charged for consultations that did not happen. Others said they were connected to digital pharmacies that quoted excessive prices of up to $700 for the cheap medication. In more than 3,000 messages reviewed by TIME, dozens of people described their or their family members’ COVID-19 symptoms worsening while they waited for an unproven “wonder drug” that didn’t arrive.

“My mom has now been admitted to the hospital with Covid,” one user wrote Aug. 12 on the group’s channel on the messaging app Telegram. “AFLDS has not returned a call or message to her and they’ve taken over $500 out of her account!”

Since its founding last year by Dr. Simone Gold, a Los Angeles physician who was later arrested during the Jan. 6 attack on the U.S. Capitol, America’s Frontline Doctors has nurtured medical conspiracies popular in right-wing circles. Created as a political project to support the Trump Administration’s economic reopening push, it ricocheted from promoting skepticism about COVID-19 to launching a national RV tour to denounce “medical censorship and cancel culture.” It promoted hydroxychloroquine as a miracle drug and billed itself as a provider of legal services for people who refuse to be vaccinated or to wear a mask, or who want to stop vaccinations for children.

The group’s profile has soared amid the rise of employer-imposed COVID-19 mandates and the emergence of ivermectin as an alternative treatment of choice for the broader anti-vaccine community. AFLD’s Telegram channels have rapidly grown to more than 160,000 users. Its website traffic has quadrupled since April, according to an analysis by the web-analytics company SemRush, which estimates it drew nearly half a million visitors in July. In the process, AFLD’s reach has spread beyond to mainstream sites like Instagram and TikTok, making it a leading purveyor of medical disinformation that erodes public confidence and hinders efforts to get the pandemic under control, experts say.

“They’re the 21st century, digital version of snake-oil salesmen,” says Irwin Redlener, a physician who directs the National Center for Disaster Preparedness at Columbia University. “And in the case of ivermectin, it’s extremely dangerous.”

America’s Frontline Doctors declined repeated requests for comment on this story. On its Telegram channels, moderators have blamed user error and overwhelming demand for the ivermectin delays and promised refunds for customers who fail to receive the consultations with doctors that they paid for. Attempts to reach Dr. Gold, the group’s founder, through her lawyer were unsuccessful.

Federal authorities are cracking down on coronavirus-related telemedicine schemes. The Federal Trade Commission has sent nearly 400 warning letters to groups and individuals marketing false COVID-19 treatments, including one missive, in April, telling a Texas medical practice to “immediately cease” promoting ivermectin or face steep fines. It is illegal under the federal COVID-19 Consumer Protection Act, enacted earlier this year, to advertise that a product can prevent, treat or cure COVID-19 “unless you possess competent and reliable scientific evidence substantiating that the claims are true.” No such study exists for ivermectin, according to the FDA.

Yet despite the FDA’s warnings about the dangers of misusing ivermectin to treat or prevent COVID-19, the drug has become highly sought after in anti-vaccine circles. Doctors and pharmacists tell TIME they have noticed a surge in ivermectin prescriptions called in by telemedicine services, and a growing number of patients demanding it as an alternative to COVID-19 vaccines. Many who fail to obtain prescriptions through groups like AFLD or find it too expensive have resorted to buying an alternative from feed stores that is designed for use in livestock, according to Telegram chats, which reveal members advising each other on proper dosages. Mississippi health officials said Aug. 20 that 70% of recent calls to its poison control center were from people ingesting ivermectin meant for livestock.A nurse checks on a patient in the ICU Covid-19 ward at NEA Baptist Memorial Hospital in Jonesboro, Ark., on Aug. 4, 2021. Houston Cofield—Bloomberg/Getty Images

The ivermectin craze reflects some of the most damaging elements of the post-Trump conservative movement, with a mixture of political profiteering, disinformation, exploitation of social media and conspiratorial thinking combining at a critical point in the pandemic. AFLD has capitalized on “the perfect storm of everything that you needed to have a large population of people susceptible to vaccine misinformation,” says Kolina Koltai, a researcher who studies the anti-vaccine movement at the University of Washington. “America’s Frontline Doctors are really good at what they do. This idea of doctors fighting the system is a narrative that is really appealing to a lot of people.”

‘A coordinated political effort’

On July 27, 2020, a small group of doctors assembled on the steps of the Supreme Court for a news conference. At the time, President Donald Trump was pushing for governors to reopen their states and conservatives had grown increasingly frustrated with lockdown measures. The physicians, who wore white lab coats embroidered with the AFLD logo, had come to repeat a range of White House talking points. They claimed the mental toll of the lockdowns was worse than the virus itself, that hydroxychloroquine was an effective treatment for COVID-19 and that masks weren’t necessary—all of which had been contradicted by U.S. health officials.

To the extent that the mainstream medical community paid attention to the group at all, it was to point out that these doctors making misstatements lacked the expertise to comment. There was no evidence that any of the doctors who spoke that day had treated patients severely ill with the virus, according to MedPage Today, a peer-reviewed medical news site. None of them were infectious-disease experts or worked in intensive-care units during the pandemic. One was best known for promoting bizarre religious beliefs, including tweeting that America needed “deliverance from demon sperm” because people were falling ill from having sex with demons and witches in their dreams. Two of the “frontline” doctors were ophthalmologists, only one of whom was still licensed.

The emergence of AFLD was a coordinated political effort months in the making. The group was the brainchild of the Council for National Policy (CNP), a secretive network of conservative activists. During a May 11 call of CNP members that was leaked to the Center for Media and Democracy, a progressive watchdog group, members complained that Trump was being slammed for his handling of the pandemic, including failing to follow scientific guidelines. The group needed their own medical professionals to promote their message, they said, in the face of data showing two-thirds of Americans were wary of restarting the economy.

“There is a coalition of doctors who are extremely pro-Trump, that have been preparing and coming together for the war ahead in the campaign on health care,” Nancy Schulze, a Republican activist married to a former Pennsylvania congressman, said on the call. “And these doctors could be activated for this conversation now.”

Eight days later, conservative groups publicized a letter signed by more than 500 doctors calling the lockdowns a “mass casualty event.” The lead signatory was Dr. Simone Gold, a licensed emergency-room physician and Stanford-educated lawyer who was working as a part-time, independent contractor in a hospital in Bakersfield, Calif. Ten weeks after the letter’s release, Gold was standing on the steps of the Supreme Court as the founder of AFLD as Rep. Ralph Norman, a South Carolina Republican, thanked the white-coated physicians for coming to “tell us the truth.” The event was hosted and funded by the Tea Party Patriots, a pro-Trump right-wing group.

While few people attended the event, a video of the press conference went viral after it was retweeted by Trump, earning some members of the group an audience with Vice President Mike Pence. And though it was subsequently removed by social-media platforms for spreading misinformation, Gold and other members made the rounds on conservative media, from Fox News to Alex Jones and Pat Robertson.

Since then, the group has positioned itself as the leading alternative medical source for COVID-19 skeptics. Its message has changed to match the moment. At first, Gold downplayed the severity of the virus. “We’re all acting as though there’s a huge medical crisis,” she said in a May 2020 video, as the number of Americans dead from COVID-19 passed 100,000. “I’m not sure that it’s front-page news.” The real issue, Gold added, was that “our constitutional rights are being trampled on right and left.”

Soon after, the group argued there was a conspiracy to suppress an effective treatment for the pandemic ravaging the globe. “If all Americans had access to hydroxychloroquine, the pandemic would essentially end in about 30 days,” another member of AFLD, a child psychiatrist named Mark McDonald, said on a video picked up by Alex Jones’ NewsWars website. The group soon partnered with a telemedicine site set up by right-wing conspiracy theorist Jerome Corsi to sell prescriptions for the medication, which Trump promoted and said he took as a preventive measure.

As it turned out, promoting fictions about COVID-19 could be profitable. AFLD built a slick website, whose domain was bought by the Tea Party Patriots, and an email list of loyal followers whom they urged to make donations. When Gold was arrested for participating in the Jan. 6 insurrection, emails to supporters requesting their “urgent and generous donations to withstand such aggressive assaults from the ruthless enemies of free speech” raised more than $400,000 for Gold’s legal defense.

In the spring of 2021, the group announced a national RV tour, which sold VIP tickets for a “meet-and-greet” with Gold for $1,000. According to AFLD Telegram channels, they frequently canceled scheduled appearances, leaving people who had taken the day off work or driven for hours in the lurch. “Hundreds of us registered and received no information or cancellation notice,” one disappointed supporter in Cleveland wrote on June 22 when the promised tour did not arrive. AFLD moderators, meanwhile, urged followers that such events could “continue only when everyone donates what they can monthly.”

By then, the group had pivoted from hydroxychloroquine and medical choice to anti-vaccine content. AFLD falsely claimed the Covid-19 vaccines were “not effective in treating or preventing” the virus and that they had killed 45,000 people in the U.S. “This is an experimental biological agent whose harms are well documented,” Gold said in a statement on the group’s website in May. The group compared lockdown measures to Communist tactics of the 1950s and urged supporters to call their lawmakers to demand they introduce a “Vaccine Bill of Rights”—versions of which soon cropped up in Wyoming, Kansas, Missouri, Minnesota and South Carolina, including boilerplate written by AFLD.

Then, as the Delta variant tore across the U.S. and people in AFLDs forums started to report themselves or their family members falling ill, the group started heavily promoting ivermectin.

‘I feel scammed.’

Ivermectin first gained prominence in December 2020, when Dr. Pierre Kory, then a pulmonary care specialist at a Wisconsin hospital, testified about the “wonder drug” to a Senate panel chaired by Wisconsin Sen. Ron Johnson, a Trump ally known has touted alternative treatments to COVID-19.Dr. Pierre Kory testifies during the Senate Homeland Security and Governmental Affairs Committee hearing titled Early Outpatient Treatment: An Essential Part of a COVID-19 Solution, Part II, in Dirksen Building on Dec. 8, 2020. Tom Williams—CQ-Roll Call/Getty Images

The anti-parasite drug, which is commonly used for horses, is approved to treat certain parasitic worms in humans. It is not an antiviral medication and there is no evidence that it is effective in preventing or treating Covid-19, according to the FDA, which says overdoses of the drug can lead to vomiting, allergic reactions, seizures, coma, and even death.

Two pharmacists told TIME said they were alarmed when they noticed an odd surge in ivermectin prescriptions called in by telemedicine doctors in recent weeks. “We’re calling it the second coming of hydroxychloroquine,” one pharmacist in Maine says, noting he had seen prescriptions come in from “quack telehealth prescribers” in Texas, Florida, Illinois and California. “It’s wild to me and other pharmacists I’ve talked to how people won’t get a vaccine that is well-tolerated and effective because it’s ‘experimental’ but they’ll take a dose of ivermectin that’s been extrapolated based on weight from equine veterinary guidelines.”

On social media, AFLD is one of the top organizations steering customers to the de-worming medication as a coronavirus treatment. On its website, people looking for “Covid-19 medicine” are told to click on a button labeled “Contact a physician” and pay $90 for a consultation. The link takes customers to another website, “Speak With An MD,” where they’re asked to submit payment information and told that one of the “frontline doctors” will call them within a few days, with sick patients being prioritized. The group describes “Speak with an MD” as a “telemedicine service with hundreds of AFLDS-trained physicians.”

But the actual service is Encore Telemedicine, a company that connects patients to teledoctors willing to write prescriptions, according to the web portal and posts by AFLD staffers. Since 2015, it appears to have been run out of a home by a golf club in suburban Georgia, according to its business registration. (Encore’s CEO did not respond to requests for comment.)

The orders made through Encore Telemedicine then go to Ravkoo, a digital pharmacy in Auburndale, Florida, whose address listed online appears to be a dilapidated white structure by a strip mall. Ravkoo is supposed to either mail the medicine or call it into a local pharmacy. (The owner of Ravkoo did not respond to requests for comment). The cost of the medicine is applied on top of the consultation fee, and varies widely, from $70 to $700, according to AFLD customers’ comments.

It’s not clear how much America’s Frontline Doctors gets from each patient referral. The service is marketed on AFLD’s site for $90, while a direct telemedicine consultation through Speak With An MD is listed at just $59.99, a $30 difference. AFLD declined to comment on whether they receive any financial benefit from the referral.

AFLD has been using this system to sell hydroxychloroquine since at least last fall. But the network has been overwhelmed by a surge in demand for ivermectin in recent weeks, according to frustrated customers.

The group’s chaotic Telegram channels are filled with questions. Some say they paid for a consultation but never received a call from a doctor. Others say they were prescribed ivermectin but never received it; still others received the wrong medications or were charged inflated prices. Customers claimed to have paid for the non-refundable consultation and the drugs, only to have their local pharmacies refuse to fill the prescription because ivermectin is not approved to treat COVID-19. All of these people reported that repeated calls and emails sent to AFLD, Encore Telemedicine and Ravkoo went unanswered.

Many users call the arrangement a fraud. “Still no drugs as prescribed! Have not heard from their pharmacy. Very disappointing,” one user wrote on Telegram Aug. 1. “They took my money though. Definitely feels like a scam.” That same day, another frustrated customer wrote: “You tell us the vaccine producers are getting rich off us. Seems like you are doing very well yourselves?”

Another user told TIME she paid the $90 and never got the doctor consultation, but did get a call from a pharmacy that charged her another $100. “I have not heard a word. I feel scammed,” says the user, who would provide only her first name, Denise.

Other supporters, who had been promised they’d speak to “AFLDs-trained physicians,” were upset when the doctor pressed them to get the vaccine during the paid phone consultation. “Not happy at all with that!” wrote one woman who said her daughter’s telemedicine doctor had told her to get vaccinated in addition to prescribing ivermectin. “I felt like I could trust them not to push the vaccine…severely disappointed.”

Dozens of messages reviewed by TIME were from people with sick family members, who were begging for AFLDs to escalate their cases. A woman named Chynthia who had paid the fee—“$90 is a lot for us,” she said—wrote that she had never been called back. “Please help! My husband is sick. And looks like he does have a hard time breathing.”

As the confusion has mounted, some have questioned the group’s motives. A user named Vinod told TIME he had been a monthly donor to AFLD but had to call his credit-card company to stop repeated fraudulent charges and ask for a replacement card to prevent other fees from piling up.

Moderators for the AFLDs group on Telegram acknowledged to frustrated users that they were overwhelmed by the demand, although they said to “blame the CDC for the blockade” of ivermectin. But they insisted that once the physician fee is paid, “this is out of AFLDs hands operationally because of HIPPA [sic].”

‘The anti-vax movement as a whole is one big multi-level marketing scheme.’

The embrace of ivermectin by the broader anti-vaccine community has expanded AFLD’s reach. On TikTok, more than a dozen accounts reviewed by TIME show young people, some of them teenagers, touting ivermectin as a COVID-19 cure and promoting AFLD as the place to buy it. “It’s done wonders for me and it’s kicked Covid’s ass,” said one young user who documented her recovery over six videos, using the hashtag #novaccine and recommending others get ivermectin through AFLD.

Dr. Siyab Panhwar, a cardiology fellow at the University of Tulane, has been using his own TikTok account to refute misinformation about ivermectin. “The unfortunate reality is that there are some doctors that push this, and it harms the entire community,” says Dr. Panhwar. “[AFLD] say on their website that they will ‘review your history’ but I call B.S. There is no physical examination…How is this medically appropriate or safe? AFLD is dangerous and needs to be stopped.” The financial incentive to push products like ivermectin should be a massive red flag, Panhwar says. “The anti-vax movement as a whole is one big multi-level marketing scheme.”Protesters against COVID-19 vaccine and mask mandates demonstrate near the state Capitol in Santa Fe, N.M. on Aug. 20, 2021. Cedar Attanasio—AP

None of this is slowing AFLD’s movement. As fights over vaccine mandates and school-masking policies ramp up, AFLD has created “Citizen Corps” chapters in almost every state, with dedicated Telegrams channels and public events, like a Texas meeting that drew 80 people to hear lectures about vaccine side effects. At the group’s “White Coat Summit” in July to commemorate its first anniversary, it cut a video of children ceremonially burning their masks while singing “We Are The World.”

AFLD has meanwhile garnered significant publicity by touting itself as a legal resource for people who want to defy employers’ mandates to be vaccinated, tested or wear a mask. AFLD has used its “legal eagle dream team” to solicit funds, but according to some donors, that promised help has also failed to materialize. “Still waiting to hear back from legal eagle,” a user named Carlos, who said he had submitted multiple forms and emails for legal help, said on Telegram on Aug. 14. “I’m about to get fired and need legal help.”

Several supporters said they were defying employer vaccine mandates based on information and advice from AFLD. “I hope you guys are right,” a user named Jeffery posted on Aug. 20 in response to a video from the group promising to fight vaccine mandates in court. “I’m about to lose my career of over 20 years, my pension and my livelihood because I’m not taking the shot.” Others say their employers laughed off the vaccine-exemption forms they’ve printed off the AFLD website. “I am losing hope,” wrote one user named Cathy on July 6. “I just spoke with a lawyer that said the proof from Frontline Doctors is a conspiracy theory.”

The pleas of customers who trusted the group have often grown desperate. “Does anyone know how long it takes to hear back from America’s Frontline Doctors about getting Covid medicine?” asked a user who said she was pregnant and having chest pain and shortness of breath from the virus. “It seems like I’ll never hear back from them in my worst moment of need.”

On Aug. 17, one man posted in the group’s Telegram that he had waited on AFLD for weeks before they canceled his consultation for ivermectin. “Wish they hadn’t because my wife is in the ICU now,” he wrote. “Had I gotten the meds she would have been fine.”

With reporting by Alejandro de la Garza, Simmone Shah and Julia Zorthian

The Wrap

Maher Breaks Down Why Californians Should Vote No on the Newsom Recall (Video)