美国国家公共电台 NPR--一瓶伊维菌素揭示了新冠病毒远程医疗的阴暗世界

What a bottle of ivermectin reveals about the shadowy world of COVID telemedicine

Transcript¹

Just before Christmas, a right-wing journalist named Ben Bergquam became seriously ill with COVID-19.

"My Christmas gift was losing my [sense of] taste and smell and having a 105-degree fever, and just feeling like garbage," Bergquam said in a Facebook video that he shot as he lay in a California hospital.

"It's scary. When you can't breathe, it's not a fun place to be," he said.

Bergquam told his audience he wasn't vaccinated², despite having had childhood asthma³, a potentially dangerous underlying⁴ condition. Instead, he held up a bottle of the drug ivermectin. Almost all doctors do not recommend taking ivermectin for COVID, but many individuals on the political right believe that it works.

The details revealed in Bergquam's video provide a rare view into the prescription⁵ of an unproven COVID-19 therapy. Data shows that prescriptions⁶ for drugs like ivermectin have surged in the pandemic, but patient-doctor confidentiality⁷ often obscures exactly who is handing out the drugs.

Bergquam's testimonial provides new and troubling details about a small group of physicians who are willing to eschew⁸ the best COVID-19 treatments and provide alternative therapies made popular by disinformation — for a price.

Ivermectin is usually prescribed to treat parasitic⁹ worms, and the best medical evidence to date shows that it doesn't work against COVID-19. The Food and Drug Administration, National Institutes of Health, American Medical Association and two pharmaceutical¹⁰ societies all discourage prescribing ivermectin for COVID-19, and many doctors and hospitals will not give it to patients who are seeking treatment.

But fueled by conspiracy¹¹ theories about vaccine¹² safety and alternative treatments, many on the political right incorrectly believe ivermectin is a secret cure-all for COVID. As millions of Americans fell ill with COVID last summer, the Centers for Disease Control and Prevention reported ivermectin prescriptions were at 24 times pre-pandemic levels. The agency says prescriptions again rose during the latest omicron surge.

A significant number of these prescriptions come from a small minority of doctors who are willing to write them, often using telemedicine to do so, according to Kolina Koltai, a misinformation researcher at the University of Washington. The same doctors frequently promote anti-vaccine conspiracy theories.

"They're profiting off misinformation, using their medical expertise¹³ as currency," she says.

A look into the world of unproven COVID treatments

Bergquam told his audience he got his ivermectin from a group known as America's Frontline Doctors. Their leader, Dr. Simone Gold, is currently facing multiple charges related to her role in the insurrection at the Capitol on Jan. 6, 2021. She is well known for spreading anti-vaccine propaganda, and she also tells audiences across the country to give her a call for prescriptions of unproven drugs like ivermectin. Her group charges $90 for the call, and Koltai believes the prescriptions are among its primary sources of income.

"I would reckon that telehealth and telemedicine is one of the major income-generating streams for America's Frontline Doctors," she says.

Last year, online publication The Intercept¹⁴ published a story based on hacked¹⁶ documents, which showed that the group was potentially making millions by selling thousands of prescriptions (Gold denies that story in public speeches, saying that the hack¹⁵ did not occur).

In his video, Bergquam thanked the doctors repeatedly for prescribing him ivermectin. In doing so, he revealed the name of the licensed¹⁸ doctor writing the prescription: Kathleen Ann Cullen.

Cullen, 54, is based out of Florida and has a troubling professional history. She spent most of last year under investigation¹⁹ by the state of Alabama, which eventually revoked²⁰ her medical license¹⁷ in November, two months before Berquam entered the hospital. The cause was her involvement in a separate telemedicine company, according to E. Wilson Hunter, general counsel at the Alabama Board of Medical Examiners.

"She was working with a telemedicine company and was utilizing²¹ her medical license to further their ability to generate billable events, without actually providing health care to the patients," he says.

In other words, Cullen was ordering a battery of expensive genetic²² tests remotely, without ever seeing or speaking to the patients she was testing. It was so bad, Hunter says, that she was ordering prostate cancer screenings for female patients, who do not have prostates.

The company Cullen was working for at the time was called Bronson Medical LLC. It no longer has a functioning website, and its owner pleaded guilty in 2020 to federal health care fraud charges.

When the Alabama board confronted Cullen, she failed to produce patient records.

"At the hearing, she knew nothing, saw nothing, heard nothing, understood nothing and did not take responsibility for her actions," Hunter says.

These are not the only blemishes²³ on her record. Cullen's medical license in Kansas was suspended for failure to pay fees. And her American Board of Internal Medicine certification has lapsed²⁵ (the board declined to say when the lapse²⁴ occurred).

In pandemic, dubious²⁶ prescriptions continue

Despite these problems, Cullen still has active medical licenses²⁷ in North Carolina and Florida. It appears she is now using those medical licenses to prescribe ivermectin on behalf of America's Frontline Doctors.

"Where's the accountability in all of that?" says Ashley Bartholomew, a nurse with No License For Disinformation, a group of medical professionals who are trying to force medical boards to take action in cases like these.

Bartholomew was the first to notice Cullen's name on the bottle. She said the entire video made her nervous because Ben Bergquam appeared to be bringing in his own outside medication to a hospital setting.

"Is the nurse aware he's also taking these prescribed medications from this doctor in Florida while he's a hospitalized patient? And is his team of doctors aware? And is the pharmacy²⁸ aware?" she asks.

Even if they were, she worries the video — which has 23,000 views on Facebook — will encourage others to bring in outside meds, increasing their risk for complications.

NPR contacted Bergquam, Cullen and America's Frontline Doctors, and none provided comment for this article.

As for the states where Cullen still holds a license, public records show the Florida Department of Health has filed two administrative²⁹ complaints, but her license is listed as clear and active on their website. The department did not respond to repeated requests for comment. The North Carolina Medical Board meanwhile would not confirm whether an investigation was underway, but Brian Blankenship, the board's deputy general counsel, says that investigations³⁰ take time: "State Agencies have to give people due process rights based on evidence," he says.

"How many patients have to suffer?"

Cullen's case is somewhat unusual. The Federation³¹ of State Medical Boards says its data show that 94% of doctors have licenses in just one or two states. The federation runs a database that helps notify states when disciplinary action is taken.

"Within a day after cataloging and categorizing the disciplinary order, we'll share with other states and territories," says Humayun Chaudhry, the federation's president.

But often states must conduct their own, sometimes lengthy³² investigations. To streamline³³ that process, Chaudhry says his organization is encouraging states to adopt a new Interstate Medical Licensure Compact that, when signed into law, would allow states to see when investigations are started against a physician. Although it would apply only for physicians who seek licensure through the compact.

For Ashley Bartholomew, the nurse fighting disinformation, this case shows just how broken America's medical licensing³⁴ apparatus³⁵ is. Cullen has already lost her license for poor telehealth practices, and yet, a tangle³⁶ of state medical boards, laws and procedures continues to allow her to write prescriptions for questionable³⁷ treatments.

"How many patients have to suffer from disinformation," Bartholomew asks, "until we actually have action?"

NPR's Sarah Knight³⁸ contributed to this report.

1 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

2 vaccinated   

[医]已接种的，种痘的，接种过疫菌的

参考例句：

• I was vaccinated against tetanus. 我接种了破伤风疫苗。
• Were you vaccinated against smallpox as a child? 你小时候打过天花疫苗吗？

3 asthma   

n.气喘病，哮喘病

参考例句：

• I think he's having an asthma attack.我想他现在是哮喘病发作了。
• Its presence in allergic asthma is well known.它在过敏性气喘中的存在是大家很熟悉的。

4 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

5 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

6 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

7 confidentiality   

n.秘而不宣，保密

参考例句：

• They signed a confidentiality agreement. 他们签署了一份保守机密的协议。
• Cryptography is the foundation of supporting authentication, integrality and confidentiality. 而密码学是支持认证、完整性和机密性机制的基础。

8 eschew   

v.避开，戒绝

参考例句：

• Eschew fattening foods if you want to lose weight.你如想减肥，就不要吃致肥的食物。
• Good kid should eschew bad company.好孩子应避免交坏朋友。

9 parasitic   

adj.寄生的

参考例句：

• Will global warming mean the spread of tropical parasitic diseases?全球变暖是否意味着热带寄生虫病会蔓延呢？
• By definition,this way of life is parasitic.从其含义来说，这是种寄生虫的生活方式。

10 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

11 conspiracy   

n.阴谋，密谋，共谋

参考例句：

• The men were found guilty of conspiracy to murder.这些人被裁决犯有阴谋杀人罪。
• He claimed that it was all a conspiracy against him.他声称这一切都是一场针对他的阴谋。

12 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。

13 expertise   

n.专门知识(或技能等)，专长

参考例句：

• We were amazed at his expertise on the ski slopes.他斜坡滑雪的技能使我们赞叹不已。
• You really have the technical expertise in a new breakthrough.让你真正在专业技术上有一个全新的突破。

14 intercept   

vt.拦截，截住，截击

参考例句：

• His letter was intercepted by the Secret Service.他的信被特工处截获了。
• Gunmen intercepted him on his way to the airport.持枪歹徒在他去机场的路上截击了他。

15 hack   

n.劈，砍，出租马车；v.劈，砍，干咳

参考例句：

• He made a hack at the log.他朝圆木上砍了一下。
• Early settlers had to hack out a clearing in the forest where they could grow crops.早期移民不得不在森林里劈出空地种庄稼。

16 hacked   

生气

参考例句：

• I hacked the dead branches off. 我把枯树枝砍掉了。
• I'm really hacked off. 我真是很恼火。

17 license   

n.执照，许可证，特许；v.许可，特许

参考例句：

• The foreign guest has a license on the person.这个外国客人随身携带执照。
• The driver was arrested for having false license plates on his car.司机由于使用假车牌而被捕。

18 licensed   

adj.得到许可的v.许可，颁发执照(license的过去式和过去分词)

参考例句：

• The new drug has not yet been licensed in the US. 这种新药尚未在美国获得许可。
• Is that gun licensed? 那支枪有持枪执照吗？

19 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

20 revoked   

adj.[法]取消的v.撤销，取消，废除( revoke的过去式和过去分词 )

参考例句：

• It may be revoked if the check is later dishonoured. 以后如支票被拒绝支付，结算可以撤销。 来自辞典例句
• A will is revoked expressly. 遗嘱可以通过明示推翻。 来自辞典例句

21 utilizing   

v.利用，使用( utilize的现在分词 )

参考例句：

• Utilizing an assembler to produce a machine-language program. 用汇编程序产生机器语言的过程。 来自辞典例句
• The study and use of devices utilizing properties of materials near absolute zero in temperature. 对材料在接近绝对零度时的特性进行研究和利用的学科。 来自辞典例句

22 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

23 blemishes   

n.（身体的）瘢点( blemish的名词复数 )；伤疤；瑕疵；污点

参考例句：

• make-up to cover blemishes 遮盖霜
• The blemishes of ancestors appear. 祖先的各种瑕疵都渐渐显露出来。 来自辞典例句

24 lapse   

n.过失，流逝，失效，抛弃信仰，间隔；vi.堕落，停止，失效，流逝；vt.使失效

参考例句：

• The incident was being seen as a serious security lapse.这一事故被看作是一次严重的安全疏忽。
• I had a lapse of memory.我记错了。

25 lapsed   

adj.流失的，堕落的v.退步( lapse的过去式和过去分词 )；陷入；倒退；丧失

参考例句：

• He had lapsed into unconsciousness. 他陷入了昏迷状态。
• He soon lapsed into his previous bad habits. 他很快陷入以前的恶习中去。 来自《简明英汉词典》

26 dubious   

adj.怀疑的，无把握的；有问题的，靠不住的

参考例句：

• What he said yesterday was dubious.他昨天说的话很含糊。
• He uses some dubious shifts to get money.他用一些可疑的手段去赚钱。

27 licenses   

n.执照( license的名词复数 )v.批准，许可，颁发执照( license的第三人称单数 )

参考例句：

• Drivers have ten days' grace to renew their licenses. 驾驶员更换执照有10天的宽限期。 来自《现代汉英综合大词典》
• Jewish firms couldn't get import or export licenses or raw materials. 犹太人的企业得不到进出口许可证或原料。 来自辞典例句

28 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

29 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

30 investigations   

（正式的）调查( investigation的名词复数 )； 侦查； 科学研究； 学术研究

参考例句：

• His investigations were intensive and thorough but revealed nothing. 他进行了深入彻底的调查，但没有发现什么。
• He often sent them out to make investigations. 他常常派他们出去作调查。

31 federation   

n.同盟，联邦，联合，联盟，联合会

参考例句：

• It is a federation of 10 regional unions.它是由十个地方工会结合成的联合会。
• Mr.Putin was inaugurated as the President of the Russian Federation.普京正式就任俄罗斯联邦总统。

32 lengthy   

adj.漫长的，冗长的

参考例句：

• We devoted a lengthy and full discussion to this topic.我们对这个题目进行了长时间的充分讨论。
• The professor wrote a lengthy book on Napoleon.教授写了一部有关拿破仑的巨著。

33 streamline   

vt.使成流线型；使简化；使现代化

参考例句：

• We must streamline our methods.我们必须简化方法。
• Any liquid or gas passing it will have streamline flow.任何通过它的液体或气体将呈流线型的流动。

34 licensing   

v.批准，许可，颁发执照( license的现在分词 )

参考例句：

• A large part of state regulation consists of occupational licensing. 大部分州的管理涉及行业的特许批准。 来自英汉非文学 - 行政法
• That licensing procedures for projects would move faster. 这样的工程批准程序一定会加快。 来自辞典例句

35 apparatus   

n.装置，器械；器具，设备

参考例句：

• The school's audio apparatus includes films and records.学校的视听设备包括放映机和录音机。
• They had a very refined apparatus.他们有一套非常精良的设备。

36 tangle   

n.纠缠；缠结；混乱；v.(使)缠绕；变乱

参考例句：

• I shouldn't tangle with Peter.He is bigger than me.我不应该与彼特吵架。他的块头比我大。
• If I were you, I wouldn't tangle with them.我要是你，我就不跟他们争吵。

37 questionable   

adj.可疑的，有问题的

参考例句：

• There are still a few questionable points in the case.这个案件还有几个疑点。
• Your argument is based on a set of questionable assumptions.你的论证建立在一套有问题的假设上。

38 knight   

n.骑士，武士；爵士

参考例句：

• He was made an honourary knight.他被授予荣誉爵士称号。
• A knight rode on his richly caparisoned steed.一个骑士骑在装饰华丽的马上。