Religious leaders in the United States said they were struggling to keep their members as safe from contagion as possible while still offering the usual comfort of gathering together to pray as a group.

Last week, the Rev. Roman Stikel, the pastor at St. Mary in Kenosha, Wis., decided to quickly make some temporary changes at his church. He sent robocalls to his parishioners warning them not to shake hands, and he is already mulling the idea of canceling Mass if the outbreak becomes a widespread emergency.

“For people who are very committed to coming to Mass and praying together as a community, this is going to be difficult for them,” he said. “What we’ll hope and pray for is that this is something that will pass.”

By Tuesday evening, there were 118 confirmed cases of coronavirus in the United States, with the death toll rising to nine. Most of the cases were in Washington State, California and Texas, including Americans who are under quarantine after being repatriated from China.

As concerns about coronavirus spread, Jennifer Baskerville-Burrows, the Episcopal bishop of Indianapolis, sent her members a note on Friday announcing changes to worship, including the switch from ceramic chalices to metal in an effort to limit the spread of germs.

“It’s all about education and trying to help, both putting people at ease and giving them what they need to make good decisions about their well-being,” Bishop Baskerville-Burrows said in an interview.

Lev Gerstle, a graduate student at the University of Hawaii at Manoa in Honolulu, noticed that the “Shabbat shalom” greetings after the opening prayers at Temple Emanuel-El were a bit more subdued than usual.