Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit

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Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
2021
                                                      IHRSA
      Global Report
THE STATE OF THE HEALTH CLUB INDUSTRY

          Supplement to Club Business International      ihrsa.org
Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
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Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
EDITOR’S WELCOME

As 2020 began, the health club
industry was robust and its future seemed
bright. By spring, however, virtually all
gyms and studios would be closed due to
the global COVID-19 pandemic. IHRSA
estimates that the U.S. industry alone lost
$20.4 billion in 2020, just one year after generating an all-time high
of $35 billion in revenue. From bankruptcies to staff layoffs, the
economic impact of COVID-19 on health clubs, gyms, and studios will
leave an indelible mark on the fitness industry.
   Of course, crisis breeds opportunity. The permanent closure of 17% of clubs in the U.S.—and
as high as 40-50% in some countries—has left a large segment of displaced members
seeking new alternatives. Many surviving clubs in these markets have already seen significant
increases in membership, outpacing pre-pandemic numbers. Now more than ever, the
public needs the environment and support club operators provide in improving the health of their
communities. On the pages that follow, we will outline many more reasons to be optimistic about
the industry’s future.
   IHRSA’s mission, to grow, protect, and promote the health and fitness industry has never
been more crucial. For the past year, the board of directors and IHRSA team have been focused
on reopening, rebuilding, and reimagining our industry and our association. To that end, they
have chosen Elizabeth Clark as the association’s next president and CEO. She previously led
government relations and advocacy at the National Confectioners Association (NCA), the trade
association for the $44 billion candy industry, and successfully lobbied the administration to have
confection manufacturing deemed “essential” during the pandemic.
   Clark succeeds IHRSA Interim President & CEO Brent Darden, who stepped in last August at
the board’s request, to lead the association out of the pandemic until a permanent CEO was
selected. We’re incredibly grateful to Brent for his time, passion, and steadfast leadership during
this challenging and critical time for IHRSA and the entire industry.
   As we look to the future, all signs point to a strong comeback. “Celebrating the Industry’s
Revival” is the theme of IHRSA 2021, which is set for October 13-15 and will be the first major
in-person industry event in nearly two years. Please plan to join us in Dallas, Texas for what
promises to be the reunion of a lifetime.

Yours in health,

Jay Ablondi                               Kristen Walsh
Publisher                                 Associate Publisher

P.S. The impact of COVID-19 on our industry has varied greatly around the world, and in some
areas, the situation improved and then became severe once again. Since this report was written
in the spring of 2021, some information may have become outdated by the time you read this.
Please visit ihrsa.org for the latest information.

                                                                  ihrsa.org   |   ©2021 IHRSA   |   IHRSA 2021 Global Report   3
Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
INDUSTRY OVERVIEW
     CONTENTS

     2021 IHRSA
     Global Report
                                                     INDUSTRY OVERVIEW
                                                      5 • Coronavirus Pandemic Pummels Global Health Club Industry
                                                      20 • Eyes on the Future

                                                     RESEARCH
                                                     21 • More Than a Year Later, Health Clubs Worldwide
                                                           Continue to Struggle with the Impact of COVID-19
                                                     24 • 2020 Global Timeline: The Pandemic & Fitness Clubs
                                                     28 • North America
                                                     30 • Latin America
                                                     32 • Europe, Middle East & Africa (EMEA)
                                                     36 • Asia-Pacific

                                                     COMPANY PROFILES
                                                     41 • Index by Country
                                                     44 • Alphabetical by Company Name, Sorted by Region

                                                     PARTNER PROFILES
                                                     73 • Alphabetical by Company Name

                                                     ADVERTISER INDEX
                                                     84 • Alphabetical by Company Name

                                    © 2021 IHRSA                                     PUBLISHER: Jay Ablondi
                                    All Rights Reserved
                                                                                     ASSOCIATE PUBLISHER: Kristen Walsh
                         ®

                                    International Health, Racquet
                                    & Sportsclub Association                         DIRECTOR OF RESEARCH AND INSIGHTS:
                                    70 Fargo Street                                  Melissa Rodriguez
                                    Boston, MA 02210 USA
                                                                                     DESIGNER: Deborah Bush Design, Inc.
                                    +1 617/951-0055, +1 800/228-4772
                                    ihrsa.org
                                                                                     To access all IHRSA publications, webinars, and
                                    healthclubs.com                                  MP3 audio recordings, visit ihrsa.org/publications.

4   IHRSA 2021 Global Report   |   ©2021 IHRSA   |   ihrsa.org
Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
INDUSTRY OVERVIEW
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INDUSTRY OVERVIEW

                                                                                                             BY KRISTEN WALSH

Coronavirus Pandemic Pummels
Global Health Club Industry
Still, opportunities for optimism abound

F
     rom bankruptcies to staff layoffs, the economic                 However, a silver lining is that crisis breeds progress,
     impact of COVID-19 on health clubs, gyms, and                inventiveness, and bold strategies. Innovative solutions were
     studios will leave an indelible mark on the fitness          developed to improve safety and air quality, and cleaning and
industry. Still, opportunities for optimism abound.               social distancing measures were put into place at facilities.
                                                                     Cleanliness at the gym has never played a more prominent
   Last year will go down in history as one of the most chal-
lenging for businesses globally, and the health and fitness       role than it does today. What used to be primarily in the back-
industry in particular. The industry was upended in ways          ground is now front, center, and continual. For health club
never before foreseen, businesses and jobs lost—people’s          members and staff, clean equals safe. And safety is king. Since
livelihoods threatened.                                           last spring, clubs around the globe have undertaken compre-
   By the end of March 2020, gym closures had become a            hensive, and often costly, efforts to optimize air quality and
global occurrence as a result of the COVID-19 pandemic, as        ensure that surfaces are frequently sanitized.
had job losses, stay-at-home orders, remote work arrange-            In addition, companies rapidly pivoted to digital offerings.
ments, hybrid or online schooling, social unrest, political       Within weeks of initial shutdowns, thousands of clubs had
divisiveness, issues of isolation, mounting depression, and, of   mobilized, rapidly creating content and offering online
course, an accelerated decline in health and wellness for most    programming on a range of streaming platforms to deliver
people around the world.                                          much-needed training to members in various stages of

                                                                           ihrsa.org   |   ©2021 IHRSA   |   IHRSA 2021 Global Report   5
Global Report IHRSA 2021 - THE STATE OF THE HEALTH CLUB INDUSTRY - FIT Summit
INDUSTRY OVERVIEW
                                                                                                           Once the pandemic began, many clubs
                                                                                                           started offering virtual programming

     lockdown. The velocity of the shift to digital class delivery was
     nothing short of amazing as well as being fairly seamless for
     hundreds of thousands of members.
        That being said, it quickly became clear that there is no
     substitute for the real thing. The extended shutdowns have
     convinced millions just how integral gyms are to their health
     and happiness. “The longer gyms were closed, the more
     the public realized how much clubs fill a need that can’t be
     satisfied with at-home workouts, explained CBI editor-in-chief
     Jim Schmaltz.
        Best of all, as a result of the pandemic, our industry has
     banded together to leverage the power of collaboration to
     share knowledge and best practices in order to help each
     other meet the many challenges this pandemic has brought.
        “The current crisis is beyond anything that IHRSA has
     endured before,” said Brent
     Darden in August, upon
     becoming IHRSA’s Interim
     President and Chief Executive
     Officer, replacing Joe Moore.
     “Although the ‘great recession’
     was a very difficult time finan-
     cially, it was not also fraught
     with the pandemic, overriding Schmaltz                                Darden                          Dr. Sallis
     absence of trust, and perceived
     lack of performance by so
     many constituents. The challenge that lies before us will be        reported reaching upward of 95% of pre-COVID attendance
     overcome through an obsession with the customers’ voice,            levels. In the U.S., leading clubs in states that have allowed
     authenticity, transparency, consensus building, and an              them to remain open with reasonable restrictions are reporting
     unwavering commitment to balance the needs of stakeholders          that 75%–80% of their customers have returned over the first
     when making the hard decisions that await.”                         few months.
        Despite the abundance of bad news resulting from the
                                                                         • The industry is maturing. Crisis breeds progress, inventive-
     pandemic, reasons for optimism abound. Here are just a few:
                                                                         ness, and bold strategies. The pandemic forced streamlining
     • Health has become more of a top priority. Buoyed by the           of staff and programs, accelerated the adoption of digital
     pandemic and persistent public messaging around pre-                offerings, fast-tracked the repurposing of spaces, progressed
     existing or underlying health conditions and immunity, being        outdoor fitness solutions, and enriched member-retention
     physically active and pursuing a healthy lifestyle has earned       efforts, among other advancements.
     heightened attention from society at large.
                                                                         • Economic forecasts related to wellness are very favorable.
     • There is pent-up demand. The shutdowns, quarantines,
                                                                         Outside the industry, investment analysts, private equity
     working from home, and isolation have created an enhanced
                                                                         groups, and market prognosticators all predict a bright future.
     desire for people to get back to the gym and back to the sense
                                                                         Inside the industry, national and regional operators are
     of community it offers.
                                                                         already aggressively seeking expansion opportunities.
     • Changing market dynamics offer opportunity. The perma-
                                                                            More promising news came in April when new research by
     nent closure of 17% of clubs in the U.S.—and as high as
     40%–50% in some countries—has left a large segment of               health care company Kaiser Permanente found that physical
     displaced members seeking new alternatives. Many surviving          inactivity is a top predictor of severe COVID-19 outcomes. Key
     clubs have already seen significant increases in membership,        findings include:
     outpacing pre-pandemic numbers.                                     1. Physical inactivity is strongly associated with COVID-19
     • Online and in-home workouts complement gym usage.                 outcomes, and physical activity provides significant protection
     Numerous studies validate the fact that consumers view              from severe outcomes including hospitalization, ICU
     virtual classes and the vast alternatives for exercising at home    admission, and death.
     to be an addition to their gym membership, not a replacement        2. Being consistently inactive more than doubled odds of
     for in-person workouts at their club.                               hospitalization compared to being consistently active. Odds of
     • The vast majority of members will return. Since reopening,        ICU admission were 1.73 times higher and odds of death 2.49
     operators in China, Japan, New Zealand, and the UAE have            times higher for the consistently inactive.

6   IHRSA 2021 Global Report   |   ©2021 IHRSA   |   ihrsa.org
INDUSTRY OVERVIEW
                                                                      Regular exercisers were found
                                                                      to be at a lower risk for severe
                                                                      COVID-19 outcomes
3. Aside from being over age 60 and a history of solid organ
transplant, consistent physical inactivity was the most signifi-
cant risk factor for COVID-19 death.
4. While meeting the U.S. Physical Activity Guidelines was
associated with the most significant benefits, even those doing
some physical activity were at lower risk for severe COVID-19
outcomes, including death, than people who remained
consistently inactive.
   One of the study’s lead researchers, Robert Sallis, M.D., said,
“This is a wake-up call for the importance of healthy lifestyles
and especially physical activity. Kaiser Permanente’s motiva-
tion is to keep people healthy, and this study truly shows how
important that is during this pandemic and beyond. People who
regularly exercise had the best chance of beating COVID-19,
while people who were inactive did much worse.”
   Dr. Sallis is a member of IHRSA’s Medical, Science, and
Health Advisory Council, which advises IHRSA’s executive staff
and board of directors on current research and science that
advances the health and fitness industry and protects public
safety while improving individual and population health.
   IHRSA is determined to be the glue that keeps the industry
together. Just in the last year, in addition to the Medical,
Science, and Health Advisory Council, the association has
launched the National Health & Fitness Alliance, the Global
Health & Fitness Alliance, the Physical Activity Alliance, and
the Industry Partner Advisory Council. IHRSA is also working
closely with several U.S. state alliances to protect and promote      IHRSA 2021 is set for
the industry.                                                         October 13-15 in
                                                                      Dallas, Texas
   In December, IHRSA intro-
duced the Active & Safe
Commitment, an initiative to
reaffirm the health club indus-
                                                                     “People who regularly exercise
                                                                     had the best chance of beating
try’s unyielding dedication to
safety at this time when exer-
cise has never been more
important to global health.
Developed by industry experts
                                                                     COVID-19, while people who
in accordance with the fore-
most public health guidance,
                                                                     were inactive did much worse.”
the Active & Safe Commitment
serves three main purposes:
1. To demonstrate the industry’s united commitment to safety         the parent company of Anytime Fitness, Basecamp Fitness,
for members, guests, and staff;                                      and The Bar Method. “We endorse IHRSA’s Active & Safe
2. To provide health club members and guests with well-              Commitment as the latest measure to send a clear message to
founded peace of mind during club visits; and                        our members, employees and government leaders that gyms,
                                                                     clubs and studios are safe and ready to help people fight
3. To reassure policymakers and public health officials that
                                                                     COVID-19 risk factors—diabetes, depression, obesity, hyper-
health clubs should not be shut down during the COVID-19
                                                                     tension, heart disease, and more—with exercise.”
pandemic, but rather should be relied upon as safe environ-
                                                                        At press time, some 1,715 clubs in 25 countries around the
ments for exercise that can serve as responsible, credible, and
                                                                     world have signed on to the Active & Safe Commitment.
effective partners for reducing the pandemic’s catastrophic
                                                                        The industry appears to be poised for a strong comeback.
toll on physical, mental, and emotional well-being.
                                                                     “Celebrating the Industry’s Revival” is the theme of IHRSA
  “The COVID-19 pandemic has worsened a physical and                 2021, which is set for October 13-15 in Dallas, Texas. It will
mental health crisis facing people around the world,” said           likely be the first major in-person industry event in almost two
Chuck Runyon, co-founder and CEO of Self Esteem Brands,              years, as well as IHRSA’s 40th anniversary celebration.

                                                                                 ihrsa.org     |   ©2021 IHRSA   |   IHRSA 2021 Global Report   7
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INDUSTRY OVERVIEW

NORTH AMERICA
After posting record numbers in 2019, the U.S. health club
industry was off to a promising start last year. No one would
have imagined that by spring, virtually all gyms and studios
would be closed.
   IHRSA estimates the U.S. industry lost $20.4 billion in 2020,
just one year removed from generating an all-time high of $35
billion in revenue. These losses represent a 58% revenue decline.
   Health clubs, gyms, and studios in all states were closed for       Flywheel Sports filed for Chapter 7
                                                                       bankruptcy in September of 2020
at least a total of one month last year. In many states such as
California, Oregon, and Washington, closures persisted for
most of 12 months. Mandated restrictions in most states
allowed limited operations ranging from outdoor or virtual-
only services to a maximum of 50% capacity.
   Continued closures and restrictions curtailed club opera-
tors’ efforts to run a sustainable business and forced many to
close down for good. Others are teetering on the brink.
   “One has to remember that health clubs are largely fixed
costs businesses. A decline in revenue to such a large degree
has devastating consequences, both short- and long-term,”
said Brian Smith, managing director of consumer investment
banking at Piper Sandler Companies, a leading investment
bank and institutional securities firm. “We are going to see
lasting effects as operators look to rebuild cash flow, recapitalize
their base business, rehire staff, and so forth.”                      YogaWorks has permanently closed its studios but
   Data from major gym and studio payment processing com-              will continue to offer digital and live-stream content
panies serving the industry reveals 19% of boutique fitness
studios had permanently closed as of December 31, 2020.                    24 Hour Fitness closed 144 loca-
Approximately 14% of gyms and traditional health clubs had             tions while Gold’s Gyms shuttered 31
ceased operations.                                                     sites. TSI ceased operation on more
   No club concept was immune to the impact of COVID-19:               than 100 establishments.
full-service health clubs, HV/LP gyms, fitness studios, and                Studio brands Flywheel, Yoga
independent clubs were all afflicted by widespread closures            Works, and Cyc Fitness filed for
and ensuing restrictions.                                              bankruptcy due to the pandemic’s
   “Compliance with mandates caused                                    financial distress. Flywheel and Yoga
many clubs, especially single-activity                                 Works closed all of their 42 and 56
studios, to close because their eco-                                   respective studios.                                       Moore
nomic model was no longer feasible,”                                       “Health club operators were hold-
said Rick Caro, a 48-year veteran of the                               ing off lenders seeking debt payments, landlords seeking full
industry and president of Management                                   rent payments, [and] members still on freeze, [all] with an
Vision, Inc., a leading consulting firm                                increased cost of operations related to safety and cleaning,”
specializing in the club industry. “Their                              said Pete Moore, founder of Integrity Square, an equity and
subsequent lack of liquidity created the                               financial advisory firm serving the Health, Active Lifestyle,
immediate need to discontinue their           Caro                     and Outdoors (HALO) sector. “Larger club groups used
operations. This has caused clubs to                                   Chapter 11 bankruptcy protection to reorganize, shed
close, costing jobs and leaving members with no alternative for        creditors, reject bad leases in order to reset and survive.
needed physical activity and social interaction.”                      Smaller footprint clubs and studios had to strongly consider
   Leading companies across the health club, gym, and fitness          filing for bankruptcy.”
studio segments filed for bankruptcy in 2020. Companies that               Last year the fitness club industry’s workforce shrunk by
filed for Chapter 11 restructuring include:                            44% as 1.4 million staff members lost their jobs. The 3.2 million
• Gold’s Gym,                                                          industry jobs were in limbo when roughly 95% of fitness
• 24 Hour Fitness,                                                     centers were closed at the peak of shutdowns in the spring.
• Town Sports International (TSI),                                         Job losses affected small business owner-operators, execu-
• YouFit, and                                                          tives, instructors, administrative staff, and seasonal workers.
• In-Shape Health Clubs                                                With continued restrictions, some of these job and career
                                                                       opportunities may never return to the industry.

                                                                                   ihrsa.org     |   ©2021 IHRSA      |   IHRSA 2021 Global Report   9
INDUSTRY OVERVIEW

           When they needed it most, Americans were essentially
        barred access to their health and fitness clubs. All through last
        year, fitness club operators struggled with closures and
        restrictions, despite the well-documented research showing
        the vital role exercise plays in boosting health and wellness.
        Club operators experienced this limited access in the stagger-
        ing decline in the number of on-site visits last year.
           While extremely rare, a few COVID-19 outbreaks were
        linked to gyms, resulting in an avalanche of negative publicity
        for the industry.
           For example, the United States Centers for Disease Control             Planet Fitness went
        and Prevention (CDC) published a study on an outbreak at a                public in 2015
        gym in Chicago in August 2020 that saw 55 people infected
        among 81 attendees of indoor high-intensity classes. Masks                  At press time, the GYMS Act had 131 Congressional cospon-
        were worn infrequently during exercise by patrons — some of              sors from both political parties.
        whom had COVID-19 symptoms. No deaths were reported                         Despite the pandemic, the market remains bullish on
        from the outbreak.                                                       Hampton, New Hampshire-based Planet Fitness. CNBC noted
           As soon as the U.S. Congress indicated that it would be               in March that the company’s stock had increased 200% over
        working on economic relief packages for businesses and                   the last year. And the chain plans to open 100 new locations
        industries impacted by COVID-19, IHRSA and its members                   in 2021 to add to its 2,124 gyms around the world.
        began working with the association’s Washington, D.C.-based                 In a March Yahoo Finance interview, Rondeau said, “As the
        lobbyists to secure the inclusion of health clubs, studios, and          vaccines get properly distributed, we see the momentum con-
        fitness equipment manufacturers in any COVID-19 economic                 tinuing through the year.” He added, “We could see a stronger
        relief package.                                                          second half than we’ve ever seen as people get back out there.”
                                                       On February 5, U.S.          Rondeau noted that 28% of people joining his club are former
                                                    Reps. Mike Quigley           members, while 4% are coming from competitors who have
                                                    (D-IL) and Brian             permanently closed. “The future is even brighter now, quite
                                                    Fitzpatrick (R-PA) filed     honestly. There’s less competition, and people are going to
                                                    the GYMS Act—or Gym          walk away post-Covid saying, ‘I should have been taking
                                                    Mitigation and Survival      better care of myself.’”
                                                    Act—(H.R. 890), which           In a deal that was finalized on April
                                                    would establish a            1, Peloton, which is headquartered in
                                                    recovery fund to provide     New York City, purchased Precor for
Quigley                     Fitzpatrick             structured relief to         $420 million. Overall, the rationale for
                                                    health and fitness service   Peloton buying Precor was three main
        establishments that have been uniquely hurt by the COVID-19              things, Rob Barker, the CEO of Precor
        pandemic. Most of Congress’s previous economic relief                    and General Manager of Peloton
        packages have either left out or not really helped the                   Commercial told CBI in an interview.
        fitness industry.                                                           “First, to leverage our U.S. manu-
           If passed, the GYMS Act will create a $30 billion fund to             facturing footprint, and not only the Barker
        provide grants to affected businesses in the health and fitness          scale of it, but also our ability to make
        industry. The fund would cap initial grant amounts at 45% of             high-quality products. Then the next one was our R&D. We
        the facility’s 2019 revenue—or $20 million, whichever is less.           have a deep R&D bench that we can bring to the company.
        Health and fitness businesses considered severely impacted—              And third was our ability to bring Peloton into the commercial
        with revenues of only 33% or less in the most recent quarter             environment. Peloton had been asked for many years by its
        as compared to 2019—would be eligible for a supplemental                 members, ‘Can I access Peloton outside of my home?’
        grant, of up to 25% of their initial grant. The most an eligible         By acquiring Precor, Peloton gets those capabilities,”
        business and its affiliates could receive is $25 million.                he explained.
           On March 11, U.S. President Joe Biden signed the American                In other major acquisition news, Fitbit, the popular fitness
        Rescue Plan Act into law. Although Congress failed to include            wearable company, was purchased by Google in a $2.1 billion
        direct relief for the health and fitness industry in this bill, there    transaction that was finalized in January. While Fitbit trails
        is still hope for financial assistance. In the recent industry action    Apple Watch in market penetration, data-hungry Google sees
        event, United We Rise – Stronger Than Ever, Rep. Quigley said,           opportunities ahead. According to Fortune Business Insights, the
        “This is not the end of the road. There are already talks of other       fitness tracker market is projected to grow to $92 billion by 2027.
        stimulus packages, and we mustn’t let up the pressure now.               Fitbit reassured their customers that data from their devices
        The federal government needs to provide assistance to your               would not be used by Google for ad purposes, but biometrics
        businesses which are hurting through no fault of your own.”              continues to be a complex subject legally for all concerned.

  10   IHRSA 2021 Global Report      |   ©2021 IHRSA    |   ihrsa.org
INDUSTRY OVERVIEW

 Early this year, Fitbit was
 purchased by Google for
 $2.1 billion

                                                                    An outbreak at a Quebec City gym made
                                                                    headlines around the world

    Looking north, the situation in Canada at press time was
                                                                    Vaccine distribution is seen as crucial to
dire. Hospitalizations were surging, intensive care beds were       the health club industry’s recovery
filling up and COVID-19 variants were spreading as a third
wave of the pandemic swept across much of the country,
Prime Minister Justin Trudeau said on
April 7.
    “Around the world, countries are
facing a very serious third wave of this
pandemic,” Trudeau told a news con-
ference. “And right now, so is Canada.”
    As Canadian provinces imposed
lengthy shutdowns on health clubs
due to the coronavirus, club operators
called upon government leaders             Anderson
and health officials to help them
safely reopen.
    “The continued closure of gyms due
to COVID-19 is an obstacle to
Canadians’ ability to maintain physical
                                          “The cost of inactivity is simply too high.”
and mental health,” observed Stacy
Anderson, brand president of Anytime
Fitness, which serves more than
100,000 citizens across 200 Canadian locations.                      Unfortunately, an outbreak at Méga Fitness Gym in Quebec
    “Worldwide, Anytime Fitness has adopted industry safety       City has become one of the largest recorded COVID-19 super-
and sanitation protocols issued by IHRSA and the Fitness          spreading events in Canada, according to the Canadian
Industry Council of Canada (FIC). We know that our locations      Broadcasting Corporation (CBC). “The health authority says
that are currently open in Canada, such as in British Columbia,   the gym was in violation of at least three public health orders
have neutralized the risk of infection while continuing to        before it was shut down. Gym staff reportedly didn’t ask
provide essential exercise and wellness services.”                patrons if they were suffering from symptoms of COVID-19,
    The FIC is also lobbying the Canadian government to           clients weren’t kept two metres apart and employees weren’t
include fitness memberships and services as a medical cost on     wearing the required personal protective equipment,” the CBC
personal taxes.                                                   reported in April.
    “We are at a critical point with our physical and mental         Gabriel Hardy, provincial spokesperson for the FIC-Quebec
health,” said Sara Hodson, the CEO of LIVE WELL Exercise          Chapter and owner of Le Chalet gym in Quebec City, explained
Clinic, and the co-chair of the British Columbia FIC coalition.   that this was an isolated event.
“The cost of inactivity is simply too high. We have to inspire       “The FIC’s member partners are working together to imple-
and encourage Canadians to get moving again today – not next      ment government health measures and to ensure a safe envi-
week, next month, or next year. It would incentivize Canadians    ronment for clients to practice healthy lifestyles leading to
if they were able to write off their gym memberships.”            good mental and physical health,” he said. “Despite the unfor-
    “Many facilities were forced to shut down completely, and     tunate situation initiated by an isolated case of non-compli-
those that have been able to operate have done so at 10% to       ance with the protocols put in place by public health and the
50% of projected revenue,” she continued. “This has not only      FIC, our industry still has one of the lowest rates of contagion
been harmful for fitness businesses, but also for Canadians’      of any industry. We are proud to be able to provide a con-
accessibility and commitment to their personal wellness.”         trolled sanitary environment for all our users and staff.”

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     LATIN AMERICA
      In April, IHRSA and the sports consultancy Management
      Around Sports (M.A.S.) reached a strategic agreement for
      Jorge Rosales to be the IHRSA representative in Mexico. The
      main task will be to meet the needs of operators in Mexico and
      to work on actions that benefit the development of the industry
      in the country.
                            “This new appointment is a professional
                         challenge to go back to my origins as a Mexican
                         and work with the operators there,” remarked         Bluefit focused on managing
                         Rosales. “Mexico is a country in full growth that    expenses in 2020
                         has been placed among the five main markets
                         in terms of club openings, and we must be by        America’s top fitness industry event. This year, the organiza-
                         its side in these moments where the industry is     tions celebrate the program’s 22nd anniversary in São Paulo.
                         suffering a hit due to the long confinement and     Event dates will be announced in the coming months.
Rosales                  the little aid that has been immersed.”                “IHRSA and Fitness Brasil have helped the Brazilian
                            “IHRSA recognizes that the economic situ-        industry navigate many challenges over the years, and we look
      ation worldwide is very challenging and we are committed to            forward to working alongside their team in the years to come
      help the Mexican fitness industry during these difficult times by      to help the entire industry recover,” said Jay Ablondi, IHRSA’s
      delivering tangible membership benefits,” added Jacqueline             executive vice president of global products. “After an uncer-
      Antunes, IHRSA director for Latin America.                             tain and tense 2020, this year’s event is poised to energize the
          For Fabián Bifaretti, CEO of Sports World, with 58 facilities      fitness industry and set a unified path forward.”
      throughout Mexico, the region’s industry has great development            The extended agreement, which comes as Fitness Brasil
      potential. “If we compare the market penetration with other            begins operations under new ownership, provides certainty
      countries in a similar path like Brazil, Argentina, or some of the     for the Brazilian fitness industry that IHRSA and Fitness Brasil
      most advanced countries of our North American neighborhoods,           will continue to assist in growing the region’s industry.
      it is observed as a big growing opportunity,” he explained.               Inaugurated in 2015 in the city of Santo André, in São
          However, the global pandemic has dealt a serious blow to           Paulo, Bluefit emerged with the purpose of ending customers’
      the market, beginning with the closure of fitness centers on           excuses for “not training” and being the most cost-effective
      March 30th, 2020. After that, Mexico started operating under           chain in the market. Years later, it became one of the largest
      the Federal Traffic Light System for its reopening, based on a         chains in the country and it continues to grow.
      color model to classify the level of restrictions: red, orange,           Led by CEO Filippe Savoia, the BlueFit chain began 2021
      yellow and green.                                                      with almost 100 stores open, of which at least 25 were opened
          “The Mexican fitness industry is in an expansion stage,            in 2020. Savoia said that of all the difficulties faced, the biggest
      despite the pandemic crisis that has badly affected operators,”        was managing expenses.
      said Jorge Rosales. “The key will be in accompanying the grow-            “We intend to expand by at least another 50 stores,” he
      ing with a bigger formality, win institutionalism and signify that     added. “But speaking of customers, we understand that the
      this industry is essential for fight against another pandemic that     moment is still very unstable. About 20% to 30% of [members]
      has taken decades slamming Mexico’s population: obesity and            still do not feel safe to return, and as long as the vaccine is not
      diseases resulted from it like diabetes or hypertension.”              available, we know that this climate will be maintained.”
          Brazil—the country with the second most health clubs in the           Based in Sao Paulo, Brazil, Monica Marques oversees fitness
      world after the United States—is seeing a surge in COVID-19            programming at Companhia Athletica’s 17 clubs, which puts her
      cases, unfortunately. But this time, as the country announces          in charge of more than 1,200 fitness instructors. As an IHRSA
      stricter rules and closures for many businesses, gyms in Rio           board member, Marques has pushed for more alliances with
      de Janeiro are able to stay open with just a few restrictions.         international health organizations in promoting inclusivity.
      The secretary of health of the state of São Paulo acknowledged            As the pandemic begins to loosen its hold on global activity,
      to the press that gym-goers seem to really comply with the             she is gratified to see the industry moving in that direction.
      safety protocols in place, and the decision to close gyms was a           “Awareness of the importance of preventive exercise
      mistake, as gyms do not pose a significant risk of spreading           increased during the pandemic and many sedentary people
      COVID-19 as long as they follow all safety precautions such as         will be interested in these programs when they feel safe to
      those preached through IHRSA’s Active & Safe Commitment.               return to the clubs,” she told CBI. “Group classes will come
          In April, IHRSA and Fitness Brasil signed an agreement that        back stronger. After a long time in isolation, people want
      solidifies event partnership opportunities for at least six years.     social, fun activities. They will be held in reconfigured
          The two organizations have collaborated on fitness industry        facilities, but it will be a strong trend.”
      events since 2000, most notably the annual IHRSA Fitness                  In March the low-cost gym chain Smart Fit signed a contract
      Brasil Latin American Conference & Trade Show, Latin                   for the purchase of 100% of the share capital of Just Fit, a net-

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     work of 27 gyms in São Paulo, Brazil.
     The amount of the operation will be
     calculated and paid after “a liquidity
     event occurs”, without the need for
     immediate disbursement.
        In a statement to its shareholders,
     Smart Fit clarified that “the closing of
     the transaction is subject to the fulfill-
     ment of certain usual conditions for
     this type of operation, including the      Marques                             Smart Fit operates more than 920 gyms in Latin America

     approval of the operation by the
     Economic Defense Board (CADE). Smart Fit is part of the Bio                  are expected to generate significant synergies, with a potential
     Ritmo group, founded by Edgard Corona.                                       increase in profitability, as well as a wider range of services
        At the end of 2020, Smart Fit received an investment of                   for their clients.”
     US$118 million. A capitalization process guaranteed US$87                       Sports World operates more than 50 sports clubs in Mexico
     million and another US$31 million came from Smartexp, a                      and is the one company in the sector, in this region of the
     subsidiary whose mission is to guarantee the expansion of the                planet, which is listed on the stock exchange.
     group. To date, the company claims to have cash of US$226                       At press time, fitness centers in Peru had been closed for
     million to face the challenges of the coming months.                         well over a year, causing losses of more than $150 million, as
        Smart Fit currently has more than 920 units in 13 Latin                   well as the suspension of employment contracts for employees
     American countries, and is the third largest gym chain in the                in the sector, mainly physical trainers who are the only source
     world, with more than 2.1 million members.                                   of income from their households. Experts in Peru estimate that
        In January of this year, this company announced that in                   30% of gyms in Peru have already gone out of business.
     2021 it would open around 60 new units in Brazil and more                       “Despite having biosafety protocols approved by the
     than 100 in the rest of Latin America.                                       Ministry of Health since September 2020, the Council of
        In April, Latamgym, a company that operates the gym of                    Ministers has not yet authorized the opening of these stores,
     the low-cost chain Smart Fit in Mexico, and the Sports World                 affecting more than 20,000 families whose livelihoods depend
     Group signed a memorandum of understanding for a “potential                  on the fitness industry,” stated Gremio de Gimnasios del Perú.
     business combination”, which could result in the formation of a              Those protocols include mandatory use of a mask, temperature
     new chain with 230 units in various states of the country.                   measurement, permanent disinfection measures, minimum
        According to a statement from Smart Fit, “the companies                   distance between people, and frequent hand-washing.

     DARK IN THE SHORT TERM, BRIGHT IN THE LONG                                        by Guillermo Velez, Editor & Director, Mercado Fitness

     The current situation of the fitness industry       doors on May 24 after two months. A bill           cination processes
     in South America is troubling. The second           to declare physical activity essential is          are so slow in South
     wave of the pandemic plus the appearance            currently under discussion in parliament.          America–except for
     of new strains of the virus is hitting the             In Peru, gyms have been closed longer           what happens in
     region hard, causing new gym closings and           than they have been open since last                Chile and Uruguay–
     delaying reopening decisions.                       December. The last reopening was on May 10         the short-term pros-
        In Chile, despite being the most advanced        with a maximum capacity of 20%. In Paraguay,       pects are not good,
     country in Latin America in the vaccination         gyms were closed between March 27 and              since the region is
                                                                                                                                       Velez
     process, gyms have been closed since                April 4. In Costa Rica, the closure of gyms was    entering the cold
     March, after having been able to operate            only one week in early May.                        months and the pan-
     intermittently for just a few weeks. And               In Argentina, gym closings began gradu-         demic is expected to hit even harder.
     although the sector expects to be able to           ally in March and increased during April.             However, as South American countries
     regain ground in the second half, the               First it was only a few cities and then entire     move forward with vaccination, government
     reopening date in Chile is not yet clear.           provinces that imposed restrictions on the         restrictions are expected to be looser and
        Uruguay is the second country in the             sector. At press time, gyms are closed in          the sector to have some continuity.
     region, after Chile, with the highest               most parts of the country and won’t be able        Undoubtedly, Europe and the United States
     percentage of the vaccinated population.            to reopen until at least May 31.                   show us the light at the end of the tunnel,
     However, the gyms were closed since                    As vaccination ratios are among the main        although we know that, unfortunately, many
     March and only managed to reopen their              indicators of recovery in the sector and vac-      gyms will not be able to survive the winter.

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                                                                       Munich will host the IHRSA Smart Summit
                                                                       in November 2021

EUROPE
As part of a new collaboration, IHRSA will hold the inaugural
IHRSA SMART Summit conference as a concurrent event of
FitnessConnected in Munich, the
Bavarian capital, November 18-20,
2021. FitnessConnected is part of the
ISPO-Network, and is headed by
industry veteran Ralph Scholz.
   “I am particularly proud about
this great partnership with IHRSA,”
said Scholz, CEO of FitnessConnected
and event director of FIBO from 2013
                                              Scholz
to 2017. “It brings us one important
step closer to our goal of being the
central European platform for the                                    a win-win for both sides, at a time
fitness industry.”                                                   when the pandemic is hurting our
   “The timing of this fitness business                              workers and our economies.”
event and the terrific destination is the                               The UK was the first to re-open
positive sign of hope the industry needs                             fitness clubs in early April. At
as we work through the current crisis                                press time, almost all European
and plan for better days ahead,” said                                countries have committed to
Alan Leach, chief executive of Ireland’s                             re-opening (fully or partially) fitness
West Wood Clubs and the incoming            Leach                    facilities by the end of June at the
chairman of the IHRSA Board of                                       latest. With gym operators keen to
Directors, effective July 1. “This new                               quickly rebuild their membership
fitness industry event has been designed exclusively for anyone      bases, many were considering
who wants to grow their fitness business, and it will focus pri-     several options such as eliminating
marily on proven fitness business growth strategies including        joining fees, offering several free
professional sales systems, expert marketing knowledge, fitness      months, and/or offering flexible Basic-Fit allows members to reserve
industry analysis and trends, member retention strategies, and       contracts in anticipation of the gym time on their mobile devices
the latest in fitness business technology.”                          quieter summer period.
   In 2021, the IHRSA SMART Summit replaces the in-person               Basic-Fit International has announced plans to open 126
IHRSA European Congress, which was originally scheduled to           clubs in Europe in 2021. With locations in the Netherlands,
take place in Berlin this past year and will resume in 2022.         Belgium, Luxembourg, France, and Spain, Basic-Fit serves
   In Europe, the last 12 months saw the fitness industry face       more than two million members in more than 900 facilities.
a major upheaval. After reopening their gyms last summer,               While the Dutch company has felt the bite of pandemic
hopes of a return to normal were quickly dented in October as        closures and other restrictions, it has seen enough promising
all clubs in Europe (with the exception of Sweden) were forced       signals to green-light the expansion.
to close down.                                                          “In spite of the COVID-19 pandemic, the lockdowns, and
   At the national level, many gym operators–with the support of     prolonged club closures, we remain confident about the
their national federations from October until April this year–       growth opportunities for Basic-Fit,” said CEO Rene Moos.
battled their national governments to ask for financial support as   “The outlook may even be better, as we believe that once the
well as stress how they can help mitigate the risks of COVID-19.     COVID-19 pandemic is under control in our countries, more
   At the international level, IHRSA sent a formal letter to EU      people will pay attention to their health and fitness and join a
trade chief Valdis Dombrovskis in December detailing the             fitness club.”
harm that new tariffs—some as high as 25%—would do to the               While leading brands such as Basic-Fit plan to expand, one
international fitness equipment industry, especially during a        cannot overlook the potential for greater market consolidation
global pandemic.                                                     in light of this unprecedented year. In Belgium, for instance,
   In March, global suppliers got some much-needed good news         where clubs were only scheduled to re-open at the earliest by
when the European Union and the U.S. announced a four-               mid-June, JIMS Fitness, the second-largest smart-cost chain
month suspension on all tariffs and EU duties. The suspensions       (with 24 clubs in Belgium and Luxembourg) was taken over by
resulted from a call between U.S. President Joe Biden and            Colruyt Group, one of Belgium’s largest retail groups, as a
European Commission President Ursula von der Leyen, who              means to reinforce its proposition in the wellness sector.
also stressed the need for a long-term solution to trade inequi-        Club owners often find it surprising when Annie Fältman,
ties relating to China and other “non-market” economies. For         owner of four 360 Träningscenter facilities in Skellefteå,
his part, Dombrovskis told reporters: “Removing these tariffs is     Sweden, tells them she was never forced to close during the

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INDUSTRY OVERVIEW

     pandemic. This is because Sweden                                    the example of Blockbuster video
     chose a different strategy to combat                                stores being replaced by the Netflix
     COVID-19. While the country’s health                                model, Viñaspre laid out a vision that
     authorities enforced restrictions on                                takes into account the changing habits
     social distancing, among other mea-                                 of consumers, some of which were
     sures, businesses in Sweden were                                    influenced by the pandemic.
     allowed to stay open.                                                  “Clubs are not going to disappear
         Fältman said that her experience                                because of home fitness, boutique
     has been far different from clubs in                                studios, outdoor sports, or online sales
     other countries in another key area:         Fältman                platforms,” he wrote. “They will disap-
                                                                                                                         Viñaspre
     virtual workouts.                                                   pear because of their inability to react
         “I have about 5,000 members [in the four clubs total], and      and adapt their business model.”
     since March, only two people have asked for virtual training,”         Specifically, Viñaspre believes that a “customer-centric”
     she noted. “I believe that once you open, people are going to       approach will make a difference. He calls for improvements in
     want the real thing. They want the customer experience. They        technology, personalization, promotion of socialization in the club
     want to be around people.”                                          environment, a refocus on customer service, and other upgrades
         Fältman says the pandemic has reinforced her belief that        to ensure a better future for the industry in his country and beyond.
     health clubs should focus on health and wellness and once and          In February, Ireland Active
     for all shed the image of being only for toned bodies.              announced the hiring of Karl Dunne
         While Swedish clubs were allowed to stay open during the        its new CEO. Dunne has worked in the
     pandemic, the neighboring Nordic countries of Denmark,              industry for over two decades in the
     Finland and Norway had to endure a much more difficult time.        areas of leisure management and
     SATS, the group of 253 clubs across the Nordic region, was          sports administration, and most
     the most impacted by closures in Norway, where capacity was         recently worked as a consultant to
     reduced by 62% in the first quarter of 2021 compared with           bring Skillnet to Ireland Active.
     22% for the same three months last year.                                “I feel very privileged to take up the
         “First of all, club owners need to                              role as CEO of Ireland Active and look          Karl Dunne
     keep expenses at the lowest level pos-                              forward to engaging with all our mem-
     sible and invest in customer relation-                              bers and stakeholders in this
     ships, so members feel safe and                                     next stage of the organiza-
     protected inside clubs,” advised                                    tion’s journey,” said Dunne.
     Giampaolo Duregon, the president of                                 “Having worked most of my
     ANIF, IHRSA’s official (and only)                                   career in the leisure, health,
     strategic federation partner in Italy.                              and fitness industry, I am
         “We need to continue to work                                    incredibly passionate and
     together with local and national               Duregon              committed to ensure our
     authorities for financial support.                                  members have the best
     Consumers want to exercise but they are afraid of committing        support and representation
     to a membership, so clubs should offer short-term payments          necessary as we emerge from
     and have more of an upselling marketing strategy. Consumers         the pandemic and start
     are more oriented toward pay-per-use services than they are         rebuilding once again.”
     to commit to annual memberships.”                                      The past year has been dif-
         In Germany, a detailed paper from the exercise biology group    ficult, said Sandra Dunne,
     at the Technische Universität München determined that health        managing director of eight Sandra Dunne
     clubs that mitigated risks from the spread of COVID-19 had          Gym Plus locations in Ireland.
     little effect on the incidence of infection in the country in the   “We first closed in March and reopened early July, which was
     summer of 2020. In addition, researchers determined that “not       great because it was so nice to welcome people back into the
     only do gyms offer over 11 million members the opportunity to       gyms. At first, we did a load of sales, then we closed down
     improve their fitness and prevent illness, but fitness training     again. The first lockdown was much harder than the second
     also helps to improve risk factors for a severe course of COVID-    because it was such a shock. You can never take for granted
     19, strengthens the immune system, and promotes mental              again how lovely it is to be in our industry serving customers.”
     health, which is negatively affected by the COVID-19 pandemic.         “There’s a natural niceness about Irish people,” she pointed
     Closure of gyms removes these important, positive effects.”         out. They’re very friendly and warm. It feels mad to not hug
         In a widely circulated article in Spain, Pablo Viñaspre,        people when you see them. I can’t bear to think of old people
     director of WSC Consulting and Fitness Management School,           being lonely, for instance, so I love that we provide an environ-
     made the case for a new business model in a provocatively           ment and a space for people to connect with others. I think that’s
     titled piece, “Fitness Clubs Are at Risk of Disappearing.” Citing   a massive part of wellbeing. We need to continue to fill that need.

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ASIA-PACIFIC
The 10th Annual ChinaFit / IHRSA China
Management Forum was held March
18-19, 2021 in Shanghai. Approximately
300 people attended the event, which
was sponsored by 11 companies.
   “This marked a very successful return
to in-person events in China,” noted John
Holsinger, IHRSA’s Director, Asia-Pacific,
who delivered a virtual update to
attendees on the state of the global health
club industry.                                    China-based operators and presenters at ChinaFit 2020/1

   In addition to Holsinger, virtual
presenters included IHRSA board
member Alan Leach, CEO of Dublin’s
West Wood Clubs, as well as Luke
Carlson, CEO of Discover Strength in
Minneapolis, Minnesota, who will join
the IHRSA board on July 1. In-person
presenters from China rounded out
the agenda, with Gold Medal Stories
presentations from 14 leading CEO
operators on the main stage, supple-
mented with breakout sessions for yoga,
youth, aquatics and facilities.
   Will’s Fitness, represented by founder
and CEO Will Wang, kindly served as the
event’s local host. LeFit, represented by
CEO Han Wei, will serve as the host of
the next event, which is planned for later
                                                  The PURE Group has 30+ clubs across South Asia
this year in Hangzhou.
   Earlier this year, IHRSA partnered
with ChinaFit to commission an evaluation of the Chinese in China. Overall, these cities have a total of 8.8 million
fitness industry. The comprehensive study was conducted members, 27,600 health and fitness clubs, and generated
by Deloitte, a leading global provider of audit and assurance, $4.9 billion in revenue (33.7 billion RMB).
consulting, financial advisory, risk advisory, tax, and                      Due to continuing local battles against the spread of the virus,
related services.                                                         and international travel restrictions, the Japan Management
   The 2019-2020 China Health and Fitness Market White Seminars will be postponed until 2022. It will still be held for
Paper focuses on 2019 market size data from the top 18 cities Japanese citizens only on June 17-19.
                                                                             The enthusiasm in China for health clubs in recent months
                                                                          is fueling a sense of relief and optimism for U.S. and European
                                                                          markets as the good news keeps on coming. Judging from Q4
                                                                          reports, business in China is exceeding expectations and
                                                                          breaking new records as people begin returning to clubs in a
                                                                          post-pandemic world.
                                                                             “Our post-COVID business rebound in mainland China has
                                                                          been very encouraging, said Colin Grant, cofounder and CEO of
                                                                          PURE Group, which has 30+ clubs across South Asia. “We’re
                                                                          seeing strong daily check-ins across many of our yoga studios
                                                                          and fitness centers, while our lead-generation and referral-
                                                                          marketing channels are doing particularly well. We believe the
                                                                          integration of wellness into mainstream society has accelerated,
                                                                          with health and fitness moving to the top of the priority list.”
                                                                             Grant said the biggest pandemic-related challenge was the
                                                                          pushback from members who believed they should be allowed
                                    The industry has begun
                                    to rebound in China
                                                                          to suspend their memberships for free.

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INDUSTRY OVERVIEW

        “We didn’t have the luxury of offer-
     ing free suspensions,” he explained.
     “Our feeling was that we have to pay
     rent, salaries, etc, and we’re staying
     open. And above all else we believe
     we’re providing a safe environment.”
        Early on, he said, Pure made the
     decision to start ramping up hygiene
     at the club level. “Perception is reality
     – it was important that members             Tan

     could see cleaners walking around the                               Luxury brand Holmes Place operates 100 clubs in 8 countries
     clubs actively cleaning on a regular basis,” he said during a
     March IHRSA webinar.
        In another sign of the increased activism and cooperation
     of the fitness industry around the world, a group of
     suppliers, health clubs, and fitness professionals in Singapore
     announced the formation of the first-ever Singapore Fitness
     Alliance (SFA). The founding members of the group include
     50 companies representing the largest fitness facilities
     suppliers, and other professionals who are committed to pro-
     tecting the industry’s interests in the health-minded country.
        Sean Tan, director of True Group and the SFA’s inaugural
     president, noted the group’s successful response to the
     pandemic is only the beginning of what they hope to achieve.
        “Singapore’s fitness industry has delivered huge health
     benefits to Singapore, well before and throughout the current
     COVID pandemic,” says Tan. “We are excited about how our            India’s Gold’s Gym Bangalore
     industry can work together, to collaborate further, and to
     ensure more people become healthier and happier, whilst
     improving their overall health, immunity, and wellbeing.”
        Fast Fitness Japan, the largest franchisee of Anytime           “Closing fitness centers is
     Fitness, debuted on the Tokyo Stock Exchange in December
     2020 with a $360 million market cap. A division of Self            hurting the public in a critical
     Esteem Brands, founded by Chuck Runyon and Dave
     Mortensen, Fast Fitness Japan has 850 Anytime Fitness
     Clubs throughout Japan.
                                                                        way, and attacking our
                                                                        healthcare system.”
        To assess the effects of its mandated closures in 2020 due
     to COVID-19, Holmes Place, a luxury health club brand with
     100 facilities in eight countries, surveyed 4,488 members of
     its 34 locations in Israel last September.
        Results validate what IHRSA and the fitness industry
     worldwide have continued to emphasize throughout the                  “Closing fitness centers is hurting the public in a critical way,
     pandemic: Gyms are essential businesses, and restricting           and attacking our healthcare system,” pointed out Holmes Place
     access is inflicting significant adverse consequences to overall   CEO Keren Shtevy in an article in The Jerusalem Post.
     public health.                                                        Contending with one of the worst rates of daily coronavirus
        For example, 81% of respondents reported that their             infections per capita in the world, Israel has ordered multiple
     health has deteriorated since clubs were closed, and 67%           nationwide lockdowns, with gyms forced to close, and then
     admitted feeling less emotionally sound without access to their    allowed to reopen, which has led to ongoing criticism of the
     fitness center.                                                    government’s efforts to effectively manage the pandemic.

18   IHRSA 2021 Global Report   |   ©2021 IHRSA   |   ihrsa.org
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