I know most indies don't mind this. I would've just liked a better option that didn't make me feel gross...
As for the others... The current offerings in "roll20 alternative" aren't really what I'm looking for. What I've tried in the past is using Owlbear Rodeo for maps, but I really just wish I had some online repo for peoples' character sheets, since most indie systems come with editable PDFs. Being able to upload those somewhere where everyone has access and edit them as we like, instead of having to send screenshots of them through Discord, would be amazing...
Having said that, after looking for such an option, I cannot find out, so maybe it isn't as simple as I assumed it might be...
The other thing I'd like to have is some way to actually draw collectively online for mapmaking games. While there are many options for this, there don't seem to be as many options for drawing cards from a deck live with other players besides using a random generator I found and screensharing on Discord. This takes away some tactility from the act though...
The problem with r20's alternatives, at least for me, is that they are considerably more complex than what I need, and sometimes equally front-loaded with bad tutorials as roll20 is. Learning my way around in r20 is overwhelming, and I feel the same way about Astral... Plus, their actual drawing functions (for mapmaking games) is about as good as Tabletop Sim's. (Which is to say, not good at all.)
I've never played tabletop games IRL. I just don't know that many people outside the internet, and none of my friends live near me so I have little choice, but I do know people who do play D&D offline and they make it sound considerably smoother even if you sacrifice QoL I consider pretty necessary. (Having to hand-write things sounds like a nightmare. I can't read my own handwriting...)