Is the pandemic over? Pre-COVID activities Americans are (and are not) resuming.

The Washington Post

13:17 JST, September 25, 2022

CarLa Bryant’s family reunion would have celebrated its 46th straight meeting this year, but there will be no such gathering of the generations. Too many of Bryant’s older relatives are still not ready to travel again.

“I’m not around too many people yet,” relatives told Bryant, 56, who lives in Prince William County, Va., and works for the Fairfax County government.

Eleven hundred miles away, in Fort Smith, Ark., Terry Davis, a 71-year-old retired Safeway manager, made his family’s reunion a priority. Although last year’s event was canceled because “we didn’t want to put the older people at risk,” this year, “people were adamant: ‘I’m not afraid, I’m coming,’ ” he said. “We’ve kind of gone on with normal life, especially things that are important to us.”

Two-and-a-half years into the coronavirus’s deadly spread, after nearly all government-imposed restrictions have been lifted, as many businesses urge or require workers to come back to their offices, President Biden declared last week that “the pandemic is over.” Yet even as the passion to get back to normal overrides years of caution, many Americans remain conflicted and confounded about what activities are safe.

Americans are coming out of the pandemic in the same kind of dynamic disarray that marked its beginning, with a crazyquilt of contradictory decisions about how to spend their discretionary time and money: Americans are flying again, but they’re not too keen on getting back aboard buses, subways and other public transit. Concert tickets are being snapped up, but theater tickets, not so much. In-person visits to medical doctors have returned to pre-pandemic levels, but mental health counseling remains overwhelmingly virtual.

The blizzard of decisions each person must make – even as the coronavirus remains highly contagious, although without nearly the severe or deadly effects it had in 2020 – can seem blinding:

“I just don’t know,” Bryant said. “I’ve had very few people at my house. This whole topic of remote work has pushed us all farther away from each other. I want our family reunion to get back to normal. I try to do things again: I went to my first movie with friends” – “Sonic the Hedgehog 2” – “but that felt weird. I had a bit of anxiety and I haven’t done it again.”

In the first year of the pandemic, the Bryant clan met online, about 60 of them, not nearly the 125 who usually attend the in-person reunions. Still, it was three hours of songs and games, stories and memories that summoned tears of joy and sorrow alike. The second year, clusters of relatives met in a few cities where the family has a significant presence. This year, covid exhaustion set in and the reunion never got off the ground.

Bryant masks up when she goes to crowded places, but she has gone to three funerals and a baby shower recently and didn’t regret it, though she did find herself edging into a corner, away from other people.

Consciously or not, every day since the pandemic began in March 2020, millions of Americans have calculated their risk of catching the virus if they take part in myriad activities that used to be routine: eating out, going to a movie or concert, seeing friends, visiting a doctor, attending a wedding or funeral.

Almost two-thirds of Americans now believe there is little or no risk in returning to their pre-pandemic lives, and 46 percent of them say they have already done so – the highest level yet recorded in an Axios-Ipsos Coronavirus Index survey conducted in mid-September.

Even though there are still about 400 covid deaths each week, many Americans have, like Davis, decided to return to activities that feed their souls or help them feel like they’re back in the world again. For family reunions, 2020’s mass cancellations and Zoom gatherings were followed by scotched plans in 2021, and this year by a surge of reunions back to pre-pandemic levels, many fully in-person, but many featuring online elements, said Edith Wagner, editor of Reunions magazine.

“There’s just far fewer hugs online, and that’s driving people back to seeing each other in person, even if they’re still apprehensive,” Wagner said.

As they choose which activities to resume, people’s priorities have varied, resulting in an economic and social hodgepodge – a country still in flux and a comeback that remains spotty.

For example, why is concert-going back to pre-pandemic levels, at outdoor rock festivals and crowded indoor arenas, but theaters, on Broadway or around the country, struggle to draw audiences?

This year, the pop, rock, hip-hop, country and other concerts put on by Live Nation Entertainment, the country’s largest concert producer, are attracting the biggest audiences it’s ever seen, more than 20 percent over 2019’s attendance, according to company data. Through this July, Live Nation had sold more than 100 million tickets, compared to 74 million during the same months of 2019, said Joe Berchtold, the company’s president.

“Everybody’s returned to pre-pandemic levels, across all venues, from small clubs to stadiums and festivals,” he said. That’s true across the concert industry, according to Pollstar, which collects box-office data nationwide. The average number of tickets sold per show jumped above 2019 levels in the first half of this year, the data showed.

But among theaters, symphonies and other arts groups, many of which appeal to an older audience, the number of tickets sold this year is down by 32 percent compared to 2019, said Eric Nelson, who analyzes research for TRG Arts, a consultancy that tracks how more than 140 arts organizations in the United States and Canada fared through the pandemic. On Broadway, the total audience was less than half the size last season as in the season before the pandemic. This fall, to appeal to older patrons concerned that theaters had lifted mask mandates, some theaters added back weekly mask-required performances.

Regional differences also explain some of the inconsistencies, with sales in the Southeast and Great Plains notably stronger than in the Northeast.

“In places that never shut down or never had mask mandates, people are more willing to come back faster,” Nelson said. “Some of those people never broke the habit, while in other parts of the country, they had long periods at home and baking banana bread replaced going out for the evening.”

At the movies, there are plenty of seats to choose from, as fewer than half of Americans and Canadians attended an in-person movie last year, according to a Motion Picture Association report. Theaters have tried to lure fans back by tearing out some seats to make room for big recliners, as well as adding food and alcohol options in many locations. But “it just takes time to get back,” said Patrick Corcoran, vice president of the National Association of Theatre Owners (NATO).

For now, the movies themselves aren’t back. The country lost about 1,000 screens in the pandemic, but half of those were sold and have reopened, Corcoran said. More than 40,000 big screens remain, according to NATO, but hefty production delays wrought by the pandemic contributed to a sharp drop in releases of both blockbusters and smaller films.

Americans want to be entertained, but the pandemic made staying home a more robust competitor to going out. “In any given year, only 20 percent of the population is going to go to a concert,” Berchtold said. “Those who want to go are going. People are getting back to their lives.”

Working Americans who used to gather at conventions are getting back on planes to popular meeting sites such as Las Vegas, Orlando and San Diego, according to the Events Industry Council, which tracks attendance.

“The demand for in-person events isn’t back to 2019, but it’s strong and growing,” said Amy Calvert, the council’s chief executive. “There’s almost this euphoria: People are so glad to see each other.” Convention organizers are catering to lingering anxiety about big crowds by adding outdoor sessions where participants walk and talk, smaller meetings, and free time for people to meet one-on-one.

Total attendance this year is running at about two-thirds the pre-pandemic level.

In Las Vegas, the return of tourists lifted the nation’s gambling mecca to record business – the same trend seen at casinos around the country: This year is on track to set a record for commercial gaming revenue for the second-straight year, according to the American Gaming Association. In the first half of 2022, total casino revenue exceeded $29 billion, nearly an 18 percent year-over-year increase.

Although online gambling boomed when the pandemic forced many casinos to close, crowds have returned to the felt tables, the association reported.

The choices Americans are making are sometimes not explainable by employer demands, age or geography. Why are weddings nearly back to normal, with full ballrooms and crowded calendars at venues, while funerals remain smaller, less likely to draw large numbers of people, and are often replaced or supplemented by online memorials?

Traditional funerals have become smaller, less formal and, in an increasing number of cases, are being skipped entirely.

Cremations now outnumber burials nationwide, with 59 percent of families choosing the less expensive option so far this year, the National Funeral Directors Association said. The trend toward cremation was well underway pre-pandemic, but it accelerated as families looked to save money or avoid travel, funeral directors said.

“Our family culture is changing fast, and the difficulty of traveling in the pandemic made that much more obvious,” said Walker Posey, who owns Posey Funeral Directors in North Augusta, S.C. “More folks are just divided. We get families who haven’t spoken to each other in years, and they don’t know if a sibling or parent is alive, so they’re not necessarily coming together in grief.”

Although many people, especially older folks, chose to stay home and watch services on a computer during the most intense phases of the pandemic, increasingly they are coming to Posey’s funeral home. “It’s very healthy for them,” he said. “When they couldn’t come together because of the pandemic, there was a lot of friction. You’d hear people make remarks about masks. It was a hot topic. But people are setting those differences aside.”

Davis, the Arkansas retiree whose family reunions resumed this summer, is glad he made attending a relative’s funeral a top priority. It’s time to put family and social connections first, he said, so he’s back to going to his doctors and attending church services, funerals and reunions.

There’s no clear pattern when it comes to which families resumed reunions this year, said Suzanne Vargus Holloman, co-director of the Family Reunion Institute. Holloman’s family scratched their event this summer, but her husband’s proceeded, drawing about 100 people in Columbia, S.C., about as big a crowd as they had had pre-pandemic.

“People all have to make their own risk calculations,” she said, “but when it’s for family, they tend to prioritize it.”

As soon as the virus hit, people vanished from many places where they used to gather: shops, restaurants, sports venues.

Much of the nation’s shopping shifted online, and the road back for bricks-and-mortar stores has been rough. Visits to indoor malls dropped 4.3 percent in August compared to the previous year, and they were down 2.3 percent at outdoor shopping complexes, according to data collected by the Placer.ai Mall Index, which tracks the locations of 30 million internet-connected devices. The picture was even worse for in-person visits to clothing stores (down 10.1 percent) and department stores (down 11.3 percent).

People have been heading back to restaurants, but “several habits that consumers picked up during the pandemic haven’t reverted back to where they were pre-pandemic,” said Vanessa Sink, a spokeswoman for the National Restaurant Association. Before covid, about 63 percent of restaurants’ business took place outside their dining rooms – takeout, delivery and drive-through. That figure soared to about 90 percent at the height of the pandemic.

In recent months, the reluctance to eat at restaurants has diminished, but not by a lot: The off-premises share of the business has dropped to about 80 percent, still well above pre-pandemic levels, Sink said.

At gyms, tracks, fields and other places where Americans get physical, “everything stopped in March 2020,” said Tom Cove, president of the Sports and Fitness Industry Association, which tracks youth and adult participation. But fairly quickly, people returned to activities that let them remain apart from each other. Participation soared between 2020 and 2022 in pickleball (up 39 percent), skateboarding (32 percent), tennis (28 percent) and golf (25 percent).

The only team sport to maintain heavy participation through the pandemic was basketball, Cove said, because it’s often played outdoors and informally, one-on-one or with close family members.

Sports such as soccer, football and baseball, which rely heavily on organized play, with coaches and referees, went into extended hibernation in many places, and when young people and adults came back to them, they tended to play less often, Cove said.

This year, the return to playing fields has been stronger in places where the action only stopped briefly in 2020, including in states where lockdowns were shorter.

“Georgia baseball teams lost maybe a couple of games,” Cove said, “while in California and New York, you lost a season and a half in many places.” Even when leagues have resumed play, it’s often with fewer teams and fewer games, as leagues have lost referees and coaches; some because they’re older and wanted to avoid covid risk, and some because “people are abusing officials more and they’re, like, ‘For $50 and a risk of getting covid, I don’t need it,’ ” he said.

The thirst to get back to youth sports is palpable, Cove said: “Kids missed being with their friends, and team sports provides that. But people have changed. Parents say, ‘Hey, we discovered we like having the family come together for dinner, so maybe we’re not traveling for sports five nights a week.’ “

Spectator sports, though not yet at pre-pandemic attendance levels, this year made strong progress toward that goal. Major League Baseball has seen attendance jump by more than two-thirds over last year, up to more than 90 percent of 2019 numbers, MLB data shows.

What hasn’t yet come back is fitness clubs, which show “the slowest return of anything we track,” Cove said. The top seven activities Americans have pulled away from all took place in clubs, starting with stationary cycling (down 40 percent), cross-training workouts (28 percent) and cardio kickboxing (27 percent.)

Some Americans haven’t gone back because they belonged to facilities near their workplace and they no longer commute. In other instances, their clubs are simply gone – about 1 in 5 did not survive the pandemic, Cove found.

Before the pandemic, the fitness club was Rose Betts’ stress reliever. A 61-year-old nurse at Grady Memorial Hospital in Atlanta, she hit the gym three or four nights a week, working out, doing weight training. She hasn’t been back since 2020.

“I don’t know if I have enough faith in people to know that they’re actually going to wipe down the equipment,” Betts said. Fearful of monkeypox and covid, she still wears a mask everywhere and only dines at restaurants outside.

She misses the ability to go where she wants, do what she wants, hold the people she wants to hold. But even as she remains cautious, there are some things she chooses not to go without, such as tending to her appearance with visits to her plastic surgeon, Stanley Okoro.

“I have things I like to maintain,” Betts said. She swears her last procedure – she had skin around her neck lifted and contoured earlier this month – made her look 10 years younger.

“I run into people and they’re like, ‘Oh, you don’t look 61!'” Betts said. “And I’m sitting here thinking to myself, ‘Yeah, if you only knew.’ People spend their money on new cars, and it makes them feel good. I spend my money on a little nip, tuck, inject, and it makes me feel better.”

Full calendars at many plastic surgeons’ offices reflect a nationwide boost in optional medical procedures. More than three-quarters of plastic surgeons report being busier now than in 2019, according to the American Society of Plastic Surgeons. The group’s survey said Americans are seeking to counter aging effects from pandemic stress and to fix up their looks before returning to in-person interaction.

“People didn’t like the way they looked on Zoom,” said Okoro, 52, a plastic surgeon in Marietta, Ga., whose practice’s revenue more than doubled between 2020 and 2021 as he did more Botox jobs, neck contouring and tummy tucks. He’s seeing more younger patients and more men.

Demand for surgery has been “mind-bogglingly explosive,” said Bob Basu, a plastic surgeon in Houston and a vice president of the plastic surgeons group’s board. His practice is enjoying its 29th-straight month of year-over-year growth, he said, drawing not just the well-to-do, but patients who considered the pandemic a once-in-a-lifetime opportunity to transform themselves while out of the public eye. “Mommy makeovers” – targeting tummies, breasts and other body areas affected by motherhood – have been huge.

“Americans feel like it’s okay to say, ‘Hey, I want to do something for myself,’ ” Basu said.

Across medical specialties, Americans are returning to their doctors’ offices, according to insurance industry claims data. Telehealth visits – by video or phone – soared from 0.16 percent of all visits in spring 2019 to 7 percent of claims a year later, according to FAIR Health, which manages a large database of insurance claims.

That number had slipped back down to 5 percent by this June, the latest month for which data is available, and remote doctor visits will probably plummet further if states tighten the licensing rules that almost all of them relaxed in 2020 to let doctors see patients by video. About half the states have restored pre-pandemic restrictions.

But while people are returning to in-person visits for medical issues, mental health providers tell a different story. Only 16.5 percent of telehealth claims are being made by primary care physicians, according to FAIR Health, whereas 63 percent of remote cases involve mental health providers.

“Patients seem to be demanding more telehealth than face-to-face meetings,” said Vaile Wright, the American Psychological Association’s senior director for health-care innovations. Often, it’s the therapist or counselor who wants to keep the visits remote. “There are fewer no-shows with telehealth, and that’s your only source of revenue, so there’s a financial incentive,” she said. That incentive could disappear if insurers revert to pre-pandemic policies and cover telehealth visits at a lower rate or only in limited circumstances.

But even therapists who like the convenience of online care say something is missing when they can’t see patients in person: “You do lose some of the nonverbal – the foot-tapping, the fidgeting, the behaviors that can be revealing,” Wright said. “You can’t take a patient outside for a walk on a telehealth visit.”