Julie Moore keeps an orange plastic bottle on her desk in Gas City, Indiana, with 14 round white pills. The other 21, she says, killed her father.
Moore remembers laughing when she first heard on the news that people were taking ivermectin, an anti-parasitic drug commonly used as a livestock dewormer, to treat COVID-19. She never expected her father, a career pharmacist, to become one of them.
Over the course of the pandemic, Moore’s father started watching online videos of doctors in white coats who claimed that alternative COVID treatments were being used effectively in India. He told his skeptical children that the studies they cited as evidence made sense. Soon after, he refused to get vaccinated for COVID-19. Instead, he paid $90 for a telemedicine appointment with America’s Frontline Doctors (AFLD), a right-wing anti-vaccine group that claimed the U.S. government was suppressing effective treatments, hospitals were killing COVID patients, and vaccines for the virus caused cancer. Moore’s father told his wife he trusted their credentials; President Donald Trump had praised the group as “very respected doctors.” A few days after the consultation, ivermectin and antibiotic pills arrived on his doorstep from a pharmacy in Alabama.
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When Moore’s father contracted COVID in Dec. 2021, he didn’t initially go to the hospital as his symptoms worsened. He believed so strongly that ivermectin would cure the virus that he refused to seek medical help until it was too late. In his final days, Moore could only watch through the glass as her dad battled delirium, trying to tear off his oxygen mask in a panic. “The worst patients we’ve seen are the ones that delayed treatment because they were self-medicating through ivermectin,” Moore says a nurse told her. “You wouldn’t believe how many people we’ve treated who have done this.” When Moore asked if any of those patients left the hospital, the nurses shook their heads no.
The extent of what Moore calls her dad’s “death by deception” only became clear after he died. In his office, she found emails and documents from AFLD outlining their “COVID protocol,” printed out and annotated with characteristic meticulousness. “My dad was a highly intelligent man. He was a fantastic pharmacist,” Moore says. “But he was also 82. They were very convincing, and they were lying.”
The COVID-19 public-health emergency expired May 11. But as the U.S. officially closes the book on the pandemic, it remains awash in tragedies like these. Ravkoo, the online pharmacy that AFLD partnered with, sold $8.5 million worth of dubious treatments for COVID drugs in 2021 over the course of 10 months alone. Many families have remained silent about this aspect of their loved ones’ deaths. Some are embarrassed or reluctant to tarnish their relatives’ memories by speaking out about how they fell prey to conspiracies or paid for unproven COVID-19 treatments. (Moore asked TIME to withhold her father’s name.)
Now these families are engaged in an uphill battle to hold AFLD and its partners accountable for what they say was a cynical, organized scheme in which doctors who swore an oath to do no harm raked in millions by peddling dubious treatments, often to the patients most vulnerable to the disease: the elderly, the isolated, those who distrusted the medical establishment or lacked easy access to health care. (AFLD did not respond to TIME’s request for comment for this story.)
So far, efforts to hold AFLD or its network of partners accountable have fallen short. Some families, like Moore’s, have unsuccessfully tried to file complaints with state medical boards to report doctors who prescribed unproven COVID-19 treatments. Pandemic emergency measures may serve to shield telemedicine practitioners from liability. Legislative efforts to sanction or suspend the licenses of doctors, nurses, or pharmacists who spread COVID-19 misinformation or promote unproven treatments have been blocked in more than two dozen states by Republican lawmakers who say disciplining them would violate free speech. A House subcommittee that launched an investigation into AFLD’s “predatory” practices following a TIME investigation in 2021 wrapped up the probe last year after its requests for documents from the group went ignored. In legal filings, AFLD has alleged it never represented itself as a medical organization, but rather a civil-liberties group that was simply providing information online.
In the meantime, these doctors have continued to thrive financially. Dr. Simone Gold, a former emergency room physician who founded AFLD, has opened a new telemedicine practice in Florida, allegedly using millions raised by AFLD during the pandemic as startup capital. Other anti-vaccine groups have continued to capitalize on their online following by charging hundreds of dollars for ivermectin consultations, which they are now promoting as a cure for non-COVID illnesses.
In Feb. 2022, Jelena Hatfield-Parker got a lunchtime call from her husband Jeremy. A 52-year-old father of three from Sparks, Nev., Jeremy Parker said he was coming down with cold-like symptoms and worried he might have COVID-19. He told his wife he would spend the night at a friend’s house. The next morning, that friend discovered Jeremy’s dead body.
It took three months for the toxicology report from the Washoe County medical examiner to come back. It concluded that Jeremy’s immediate cause of death was “sudden death in the setting of therapeutic use of hydroxychloroquine”—an anti-malaria drug that is also used to treat diseases like lupus, but is not indicated for treatment of COVID-19.
The previous summer, Jelena discovered, Jeremy had started following AFLD online after listening to podcasts that promoted conspiracies about COVID-19. At the time, the group was producing slick videos on social media, falsely claiming that U.S. health agencies were withholding life-saving treatments, and that doctors refusing to prescribe them were like “good Germans who allow the Nazis to kill the Jews.” Jeremy, who worked as an industrial sandblaster, became convinced that hydroxychloroquine and ivermectin were the only effective treatments for the virus.
On Aug. 26, 2021, Jeremy paid $90 for a consultation through AFLD’s online telemedicine portal. He was connected to a doctor named Medina Culver, 33, an osteopathic physician and Instagram influencer based in Henderson, Nev. Culver did not see or examine Jeremy. Over the phone, she prescribed him hydroxychloroquine for COVID-19 treatment or prevention, according to a receipt reviewed by TIME. Soon after, Jeremy received a prescription for 200mg of hydroxychloroquine in the mail from Ravkoo, a Florida-based pharmacy chain partnered with AFLD. According to his widow’s lawsuit, he took those hydroxychloroquine pills the night he died.
Read More: How an Online Pharmacy Sold Millions Worth of Dubious COVID-19 Drugs — While Patients Paid the Price
Jeremy’s family is suing both AFLD and Culver in Nevada district court for in excess of $30,000 in damages. The lawsuit, which was filed in February on behalf of his estate and cites TIME’s 2021 investigation, alleges that his death was linked to the falsehoods spread by AFLD as well as the doctor who prescribed it. “They didn’t even examine him. They gave him something that he used as they prescribed, and it killed him,” Jelena Parker-Hatfield says. “How can they not be held accountable for something? How in America can this be a system that works, that everybody is okay with?”
Culver did not respond to TIME’s request for comment. Jose Jimenez, a lawyer representing Gold, defended AFLD’s actions and noted that there have been cases of adverse reaction to the COVID-19 vaccines, too. “You can probably write a lot of stories where families have been saved by ivermectin and hydroxychloroquine,” he told TIME. “Sometimes, regrettably, we focus on the small percentage of the population where…that maybe isn’t successful.”
In March 2020, then-Nevada Gov. Steve Sisolak signed an order barring pharmacists from filling prescriptions for hydroxychloroquine to treat COVID. Later that year, the U.S. Food & Drug Administration revoked its Emergency Use Authorization and warned against its use for COVID. Dr. Robert Bruce Bannister, a retired ER physician and medical-school professor at the University of Nevada retained by Jeremy Parker’s family, says Culver should not have prescribed a drug that isn’t indicated for COVID-19 treatment over the phone, and should have noted the possible side effects.
“The remote telemedicine visit did not allow sufficient interaction with Mr. Parker to determine if he was at increased risk by taking hydroxychloroquine, a medication with known cardiac side-effects and warnings,” Bannister wrote in a statement filed with the Parker estate’s complaint. “A physical examination was not performed, diagnostic tests, most importantly an electrocardiogram, were not performed to evaluate Mr. Parker’s cardiac rhythm, to ensure that the hydroxychloroquine could be safely prescribed.”
Culver’s lawyers have argued that she is immune from liability under the Public Readiness and Preparedness (PREP) Act, which they allege allowed practitioners like Culver “to focus on using every available means to combat a pandemic and save lives without being chilled in their efforts by the threat of litigation.” Meanwhile, AFLD has distanced itself from its previous telemedicine work, deleting all mentions of its telemedicine consultations from its website, according to a review of previous versions captured by TIME in 2021. “While AFD does work closely with medical doctors in aggregating and disseminating information about healthcare options in America, AFD is not a medical organization that consults with patients, provides diagnosis, or prescribes treatment,” the group’s CEO said in a legal filing, describing it as a “civil liberties organization.”
Yet Parker’s emailed receipts from the group, which his wife discovered after his death and shared with TIME, show that the telemedicine consultation was described as “America’s Frontline Doctor’s virtual visit” along with a receipt labeled “America’s Frontline Doctors Prescription” from “America’s Frontline Doctors Team.” At the time, its website openly touted its telemedicine service as connecting patients with “hundreds of AFLD-trained physicians,” according to TIME’s investigation.
The case, which will test the difficulties of holding groups responsible for their behavior during a period of loosened telemedicine regulations, could drag on for years. But Hatfield-Parker says she’s undeterred. “We’re not the only family going through this,” she tells TIME. “That’s why I feel like we had to stand up and say something…[these doctors] lives haven’t changed. If anything they have gotten more comfortable, and ours have been completely destroyed.”
While Hatfield-Parker, a bilateral amputee, struggles to keep up with her three children alone, Simone Gold is living in a $3.6 million mansion in Naples, Fla., allegedly purchased with AFLD funds.
The founder of AFLD served 48 days of a 60-day sentence for participating in the breach of the U.S. Capitol on Jan. 6, 2021. Last summer, Gold received a medical license from Florida and subsequently launched a new “medical freedom” online practice called GoldCare, according to a review of Florida business records. GoldCare offers memberships for $200 per month. “Don’t stay with a doctor that restricted access to life-saving medication because Fauci told them to,” promotional materials on its website say. A lifetime membership to the practice runs $20,000. None of these fees include doctor visits, for which the service charges $400 per hour in pre-paid tokens.
Since last fall, Gold has been embroiled in a legal battle over control of AFLD with the group’s other leaders, who have accused her of lavishly spending AFLD funds and using its money and employees to set up her new practice. According to a lawsuit filed by AFLD’s board, Gold used the group’s funds for personal expenses at a rate of nearly $50,000 a month, including $12,000 per month for a personal security officer, $5,600 per month for a housekeeper, Peloton exercise bikes, and the purchases of a Mercedes Benz Sprinter van, a Hyundai Genesis, and a GMC Denali. Gold maintains that the expenses were incurred for company purposes.
Gold’s legal troubles don’t seem to have had a big impact on her bottom line. “I have raised millions, intend to raise millions more, and have incredible ideas for 2023,” she wrote in an email to AFLD lawyers in Oct. 2022, which was made public as part of the lawsuit brought by the board. Both her Telegram channels associated with AFLD still have more than 200,000 followers, who use the forum to discuss everything from how to administer ivermectin to children to using body-weight charts to determine proper dosages.
Gold isn’t the only ivermectin-promoting doctor who seems to be financially thriving. Dr. Pierre Kory, who leads the Front Line COVID-19 Critical Care Alliance (FLCCC), a network of doctors promoting alternative COVID treatments, launched an “advanced COVID-19 care center” for patients with Long COVID. It charges $1,650 for an appointment with him for “post-vaccine syndrome” or other issues. Another FLCCC doctor, Fred Wagshul, has continued to sell ivermectin consultations for $211 apiece.
Read More: Congress Is Looking Into Groups Profiting From Fake COVID-19 Drugs After TIME Investigation
In a Morning Consult/de Beaumont Foundation poll released in March, almost three in four physicians said medical misinformation hindered their ability to treat COVID-19 and hurt outcomes for their patients. Yet attempts to hold those responsible for such misinformation have largely flopped. State medical boards’ efforts to punish doctors who continue to profit off misinformation have been stymied. By last year, Republican lawmakers in half the states in the U.S. had introduced bills to prevent regulatory bodies from punishing doctors, nurses and pharmacists who promote COVID-19 misinformation or unproven treatments, according to the Federation of State Medical Boards. Other bills being discussed in several states would prohibit medical boards from disciplining physicians for COVID-19 “free speech.”
Despite a lack of medical evidence, AFLD has expanded to promoting ivermectin as a “life-saving cancer treatment” for a range of diseases, including renal and ovarian cancer. An internal AFLD document from March 2023, which was revealed in court filings, includes a proposal for the group to “explore options to reinstate its Telehealth services.”
In March 2022, Julie Moore filed a complaint with the Ohio Medical Board against the AFLD-connected doctor who prescribed her dad ivermectin, arguing that the doctor gave him unproven drugs knowing that he had been referred to her by an anti-vaccine conspiracy group. In an emailed letter sent last November, which TIME reviewed, the board told Moore that “no further action was justified.” It’s hard for Moore to stomach that there may never be consequences for what she describes as a “long, lethal con.”
“What happened during the pandemic was so wrong, and it was so evil and it was so unjust, that vulnerable people like my father got duped by these so-called doctors,” Moore says. “Where’s the accountability? How much money did they make off this? What price was my father’s life worth?”
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Write to Vera Bergengruen at vera.bergengruen@time.com