Update - March 21, 2020: This story contains information that is out of date. Public health officials now advise against all events. Find our most recent stories on coronavirus here.

The global coronavirus outbreak has shut down its first major event in Toronto after Ottawa-based e-commerce company Shopify on Friday cancelled its annual Unite conference.

Countries in Europe, Asia and the Middle East have already put the brakes on mass gatherings — from concerts, to trade shows to soccer matches — as the WHO raised the global risk level over the COVID-19 epidemic to “very high,” Friday.

Meanwhile, in Canada, the risk remains relatively low, with just 14 confirmed cases, no deaths and no confirmed local transmission. But could Shopify’s decision to cancel its May event be a sign of things to come? Is it paranoid or prudent to wonder if big events should go on?

Infectious disease expert Isaac Bogoch said it’s not too early to be thinking about these questions.

“We’re at the precipice of a pandemic,” he said. There’s still a lot that’s unknown about COVID-19, but what does seem clear points to risk from mass gatherings — the virus is known to be transmitted through droplets spread after an infected person coughs or sneezes, and through close contact.

“It’s well-known that large gatherings are opportunities that can really facilitate transmission of infections,” Bogoch said.

Organizations and businesses are rightfully concerned for the safety of their employees, they also don’t want to be known as the company that “ruins Toronto” by holding the event that sparks a local outbreak, he said.

Still, it’s not yet clear that cancelling is the right call, as that probably depends on factors like who’s coming to an event, and where they’re coming from.

For example, a conference full of people from Milan — one of the European epicentres of the outbreak — may not be the best idea at this moment, but a Jays game at Rogers Centre is likely “no problem.”

“We know the risk today is low, but of course that is going to change in the days and weeks ahead,” he added.

Other countries are already grappling with these questions.

With only eight cases so far, Switzerland has fewer infected people than Canada, but it shares a border with the hard-hit Italian province of Lombardy.

On Friday, the Swiss cancelled all events with more than a thousand people until mid-March, stopping everything from soccer matches to the massive Geneva International Motor Show.

In South Korea, where over 2,300 people have been infected and the virus is spreading locally, international pop-stars BTS cancelled their upcoming concerts.

Japan, which also has had local transmission, has shut down all schools for a month and officials have said they are considering cancelling or postponing the Tokyo summer Olympics, although they have said they will wait until May to make a decision.

“I think that’s very responsible,” Bogoch said, noting there was also talk about cancelling the Rio Olympics in Brazil during the height of the Zika epidemic in 2016. The difference is that Zika is transmitted primarily through mosquitoes, while COVID-19 is a respiratory virus that can go anywhere in the world.

The last time the Olympics were cancelled was in 1944 due to the Second World War.

The current guidance from the World Health Organization says that there is “ample evidence that mass gatherings can amplify the spread of infectious diseases,” and that organizers should have plans to manage public health issues.

The decision to cancel or postpone an event should be made through a “thorough” risk assessment “in partnership with local and national public health authorities.”

Factors to take into consideration include crowd density, how people are interacting — are they in a mosh pit or a board room? — and the number of participants coming from affected areas.

A Shopify spokesperson said in a statement to the Star that over the last two years “more than a thousand partners from all over the world have gathered in Toronto” for the Unite conference on the future of commerce.

“Due to the evolving public health concerns around COVID-19, we’ve made a hard but necessary decision to cancel the in-person element of Shopify Unite this year. We believe this is the best option to make sure we don’t put anyone’s health and safety at risk. We’ll share more updates in the coming weeks,” the statement added.

Other events are continuing: Thousands of members of the mining industry, investors and government officials from around the world will be in town this weekend for the Prospectors and Developers Association of Canada conference at the Metro Toronto Convention Centre. (Outside, the conference is expected to met by groups of people protesting in solidarity with the Wet’suwet’en blockades.)

The conference’s organizers will be cleaning and disinfecting all “high-volume touch points” including registration touch screens, washrooms, door handles and microphones, and will be making hand sanitizer available to attendees, according to a statement posted on the conference website.

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Maple Leaf Sports and Entertainment, the company that owns Toronto’s NHL, NBA and MLS teams, is also adding more hand sanitizer stations at its venues, spokesperson Dave Haggith said.

He added the company is in regular contact with Toronto Public Health “to implement their recommended measures to prevent any risk to the general public and those attending events in our venues.”

Those recommendations also encourage residents to get their flu shots, wash their hands regularly and stay home if sick — all the usual measures during cold and flu season.

The province’s Health Promotion and Protection Act gives the chief medical officer of health broad powers to take action to limit public health risks.

In an email to the Star, Dr. Eileen de Villa, Toronto’s medical officer of health, said Public Health Toronto is “closely watching” what other countries are doing to contain COVID-19, including postponing large gatherings and events and limiting places where people gather in large numbers.

Toronto is not yet in this type of situation, she said, but such shutdowns “standard” measures in the public health arsenal to tackle serious outbreaks.

“Actions like these need to be assessed, evaluated and taken only after we balance preventing the spread of infection with the need for people and communities to function,” she added.

Frederic Dimanche, a professor at Ryerson’s Ted Rogers School of Management, said the virus has “tremendous” potential to cause economic damage, and cautioned against overreaction.

“We have to be careful collectively about the consequences that we’ll have on the global economy,” he said.

Even though local events are not yet being cancelled en masse, Toronto is already likely to see a hit from fewer overseas tourists, Dimanche said.

“On the one hand, you want to tell people you have to be careful, you have to follow the recommendations by the World Health Organization and the Ministry of Health,” he said.

“But beyond that, we have to be careful not to be panicking.”

Fellow Ted Rogers professor Vik Singh, who said he has already seen fewer crowds at the Eaton Centre next to his office, said businesses should have “contingency plans” for working remotely if the need comes to cancel large gatherings.

There are also of liability around sending employees overseas for business events in a rapidly changing global situation.

But, like his colleague, Singh cautions against going too far, especially after the stock markets had their worst week in years.

One risk is the concept of “cocooning,” he said, which happens when people choose not to go out to eat or to a Raptors game, even though the risk is low in this country right now.

“I’m afraid that might translate into a drop in consumer confidence, and that’s a slippery slope,” he said.