ATLANTA (Reuters) - With a wide smile and arms outstretched, but quickly dropped into double elbow bumps, James Harper warmly greets fellow congregants at Our Lady of Lourdes Catholic Church on Sunday in Atlanta’s Old Fourth Ward neighborhood.

Parishioners raise their hands, rather than engaging in the tradition of holding hands, during the saying of the Our Father prayer, as a precaution against the coronavirus at Our Lady of Lourdes Catholic church in Atlanta, Georgia, U.S. March 8, 2020. REUTERS/Christopher Aluka Berry

“We’re all tight here,” said Harper, 51, a salesman. “Normally it’s nothing but deep hugs. But it’s a different day now.”

Churches across the United States are advising parishioners to avoid direct contact with fellow members as an oft-reiterated warning against spreading the coronavirus, which emerged in China last year and causes the sometimes deadly respiratory illness COVID-19.

At least 19 people have died out of about 450 reported cases in the United States. The outbreak has killed more than 3,600 worldwide.

Reverend Jeffery Ott, pastor of Our Lady of Lourdes, said that the biggest change on Sunday was omitting the ceremonial sharing of wine in the common cup, or chalice, during the Holy Communion service, as well as receiving the wafer or bread in the hand only, not the mouth.

“Traditionalist may want the service, but this is not just the flu,” he said. “We are all responsible to stop the spread.”

The instructions, now widespread across archdioceses across the nation, involve changes to relatively new ceremonies, such as the exchange of peace, which was introduced in the 1960s, as well as age-old traditions such as Holy Communion that are at the core of Catholic ritual.

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Thomas Groome, a professor of theology at Boston College and a former priest, said the new measures show how seriously the church is taking the risks of coronavirus.

“All of these things are traditions that many are sentimental about,” he said. “But none of these symbols are essentials to the church.”

Traditionally Catholics embrace or shake hands during the so-called “exchange of peace” while repeating the greeting “peace be with you.”

But the Roman Catholic Archdiocese of Atlanta is one of many that have told parishes to discourage physical contact during the ritual, which is designed to remind worshippers they are members of a community. Some dioceses want the “peace” ceremony eliminated all together until the coronavirus outbreak abates.

As an alternative to touching, the Archdiocese of New York is encouraging worshippers to wave at fellow parishioners during the greeting, said Joseph Zwilling, a spokesman for the archdiocese.

Groome said that at his church in Boston, the congregation nods or trades fist-bumps.

“This is the responsible thing to do,” he said.

In the Archdiocese of Miami, churches have been urged to empty the holy water fonts at the church doors as a precaution. When entering a church, many Catholics dip their fingers in the fonts and make the sign of the cross with the water which a priest had blessed. Experts say it is an obvious conduit for infection.

Keeping people healthy is more important than tradition, Reverend Ott said.

“Some of our older members might not like the changes but we have to be responsible,” he said.