The novel coronavirus and the 2020 Democratic primary may be on a collision course, with increased fears about COVID-19 becoming more prevalent ahead of a crucial day of voting.

Illinois, Arizona, Florida, and Ohio are all set for an election day Tuesday with governors in each state having already declared emergency measures because of the virus. Officials are now balancing assuaging health concerns while encouraging available early voting options in a Democratic primary that may be nearing its end.

“It’s a bizarre and kind of sad environment to close a campaign on,” Ohio Democratic Party chairman David Pepper said.

More states have been scheduled to vote in the weeks to come, but there are already indications this may change as state governments grapple with how to best handle the unprecedented crisis.

In Louisiana, the secretary of state announced Friday the state plans to postpone its April 4 primary to June 20.

“When I contacted the governor’s office, I think that there was some relief in us coming to that decision,” Louisiana Secretary of State Kyle Ardoin said during Friday's press conference.

Just a day later, elections officials in Georgia made a similar announcement. Secretary of State Brad Raffensperger said that in order to protect the public amid the coronavirus pandemic, the state's primary would be bumped back from March 24 to May 19.

Amid the health fears, some worry how the virus will affect turnout and poll worker numbers as the response to the health issue continues to evolve. The voting comes as major events, college classes, and even the rest of the NBA season have been put on hold as containing COVID-19 troubles the nation.

“Obviously folks are concerned that it will depress turnout and that appropriate steps will not be taken to make everything work as smoothly as they are,” said Myrna Pérez, director of the Voting Rights and Elections Program at the Brennan Center. “But I would be hopeful that election administrators will do what they can in the time that they have to put voters more at ease.”

The scare comes at a crucial time for the Democratic party, when the major contenders have been winnowed to former Vice President Joe Biden and Sen. Bernie Sanders (I-VT). Biden’s string of success since South Carolina has him primed to win the Democratic nomination, just weeks after Sanders was seen as a frontrunner for the top of the ticket following the Nevada caucuses.

Despite Biden outpacing Sanders in voting earlier this week, Sanders committed to staying in the race and debating Biden on Sunday. That makes Tuesday’s next round of voting critical, and could help Sanders make a comeback or relent and leave the race. The 78-year-old failed to win any of the four states set to vote Tuesday when he ran in the Democratic primary in 2016.

Ohio's secretary of state announced earlier this week he was ordering that specific polling places in senior citizen living facilities and nursing locations be moved ahead of the primary. He also encouraged Ohio voters to vote early in the state's primary, whether that be in person or by mail.

Poll workers have also reportedly been a point of concern. A strong election calls for many poll workers, Pepper said, and there's a need for more. In Ohio, the secretary of state and governor are asking people to step up, Pepper said, and he is doing the same.

"A lack of poll workers means you potentially have long lines and other things like that, which are valid concerns," Pepper said.

The situation heading into Tuesday has also sparked concern from Kristen Clarke, the president and executive director of the Lawyers’ Committee for Civil Rights Under Law.

"With many of the eleventh hour polling site changes that election officials are making, we anticipate that there may be confusion on the ground and poll workers who will be in the dark about their newly assigned polling site," Clarke said.

The impact on turnout is unknown at this point, she said, but circumstances like a poll worker shortage in one Florida county also troubled her.

"What this moment shows is that election officials are woefully unprepared," she said about the impact of the virus on the primary elections. "I think that officials need to do a better job anticipating events that can disrupt the process and need to do a better job having in place safeguards and contingency plans that can help ensure that voters have access at the end of the day."

Similar precautions to Ohio's are also being taken in Illinois, said Matt Dietrich, the spokesman for the Illinois Board of Elections. But Illinois doesn’t have the same top to bottom authority, he added. It follows a “bottom up election system,” Dietrich said, meaning the 108 local election authorities who conduct the voting are the ones responsible for the polling places.

“This is an unprecedented situation,” Dietrich said. “But we are hopeful that by taking proper precautions, people can balance their sense of civic duty with the need to protect themselves and others from what is emerging as an extremely serious health threat.”

The Centers for Disease Control and Prevention also issued updated guidance for voting sites earlier this week. The advice included telling polling workers to “practice hand hygiene frequently,” and to “clean and disinfect voting-associated equipment routinely.” Voters who plan to cast a ballot in person on Tuesday are being urged by the CDC to head to their polling places at “off-peak times.”

The leading election officials in the four states set to vote on March 17 said in a joint statement Friday that they “are confident that voters in our states can safely and securely cast their ballots in this election.”

A short while later, Sanders was asked during a press conference in Burlington, Vermont about difficulties in making it to the polls in the current health climate.

“Again, re-scheduling elections is not something we do lightly or should do lightly,” Sanders said. “On the other hand, at this particular moment it is absolutely appropriate that public officials, governors, etc., listen to public health officials and your point is also important, to make sure that everybody who wants to vote has the right to vote and that may not be the case today.”

Ahead of Tuesday’s election, a spokesperson for the Florida Democratic party also said in an email Thursday that the party “has decided to postpone or cancel events that would have 250 or more people in attendance for the time being.” A spokesman for the Arizona Democratic Party then announced Friday the cancellation of its election night watch party because “public health is paramount.”

In Arizona on Friday, Maricopa County Recorder Adrian Fontes’ office announced he was sending “ballots by mail to all voters that typically vote on Election Day and are eligible for the Democratic Presidential Preference Election.”

The move, according to the official’s statement, will help voters practice social distancing because it allows people to “just drop-off the voted mail ballot at a voting location.”

The decision was made in part, according to the statement, because of “a lack of cleaning supplies available to meet County Health Department directives for preventing the potential spread of disease in the polling places.”

Taking to Twitter later in the day, Fontes said officials “are in unchartered territory with COVID-19.”

“My first concern is to protect the health of the voters and staff who work in the polling places while maintaining the integrity of the election,” he tweeted. “I am sending ballots to remaining voters today.”

But a swift rebuke came from Arizona’s attorney general moments later on social media, who said Fontes “cannot unilaterally rewrite state election laws,” in response to the earlier tweet.

“We are on our way to court now to file a motion for TRO and a Preliminary Injunction against Adrian Fontes and Runbeck Election Services to stop them from violating Arizona law,” Arizona Attorney General Mark Brnovich tweeted.

Florida’s leading election official has also made a plea similar to the message sent by her Ohio counterpart.

“Voters with symptoms of #COVID19 can designate someone to pick up their vote-by-mail ballot for them as late as Election Day by filling out affidavits for that designee,” Florida Secretary of State Laurel M. Lee tweeted Tuesday.

In Florida’s Miami-Dade County, an election spokesperson downplayed concerns that the virus could affect turnout. Suzy Trutie, a spokesperson for the Miami-Dade County Elections Department, described Florida's presidential preference primary as traditionally seeing low voter turnout.

“So far voters have been voting in the methods and in the numbers that we have anticipated, so we're not concerned,” Trutie said. “What we want to ensure is that voters are confident that they can come vote in a safe environment and that the process will be very positive for them and that it won't take much time.”

Both Biden and Sanders canceled major campaign events March 10 in Ohio because of public health concerns. The two Democratic contenders each made their own speeches about the pandemic Thursday. And the next Democratic debate, set to be held Sunday, will now take place in Washington, D.C., rather than in Arizona and will not have a live audience.

“Something for this scale and this level of concern is something that I haven't seen before,” Pérez, at the Brennan Center, said of the Tuesday’s primaries backdrop.