Religious institutions should provide soap and hand sanitizer, encourage the use of cloth masks and clean their facilities daily if they want to open while coronavirus is still spreading, the US Centers for Disease Control and Prevention said in newly released guidance Friday.
Churches, synagogues, mosques and other institutions should also promote social distancing and consider limiting the sharing of objects such as books and hymnals, the CDC said.
The new guidance comes at the urging of the White House, which has been in a tug-of-war with the CDC over pandemic guidance.
The CDC posted detailed guidelines on how to safely loosen coronavirus pandemic stay-at-home orders on the agency's website earlier this week after references to faith-based guidance were "stripped" from the final document, a senior CDC official told CNN.
President Donald Trump had said he would push the CDC to issue new guidance.
"I said, 'You better put it out,' " Trump told a roundtable in Michigan on Thursday.
At a White House press briefing Friday, Trump said that the guidance would deem places of worship "essential," adding that he wanted Americans to go back to church and calling on governors to reopen religious institutions for services.
But the recommendations are voluntary, and the administration has not explained what authority Trump would use to "override" governors' decisions to keep places of worship closed.
The guidance states, "Millions of Americans embrace worship as an essential part of life."
The new guidance is more detailed than initial advice published on the CDC's website, while offering leeway to organizations to make their own decisions about what they should do to limit the spread of the virus.
"For many faith traditions, gathering together for worship is at the heart of what it means to be a community of faith. But as Americans are now aware, gatherings present a risk for increasing the spread of COVID-19 during this public health emergency," the CDC says in the new guidance.
While initial arguments between the CDC and the Health and Human Services Department's Office of Civil Rights were over references to hymnal books and communion cups, according to an official involved, the new guidance explicitly references multiple religious objects.
"Consistent with the community's faith tradition, consider temporarily limiting the sharing of frequently touched objects that cannot be easily cleaned between persons, such as worship aids, prayer rugs, prayer books, hymnals, religious texts and other bulletins, books, shared cups, or other items received, passed or shared among congregants as part of services," the guidelines state.
Most of the guidelines resemble advice given for any organization, such as encouraging people to wash their hands, cover coughs and sneezes and cover their faces. It also suggests limiting the numbers of people at weddings, funerals, educational events, classes and support groups.
"Provide physical guides, such as tape on floors or walkways and signs on walls, to ensure that staff and congregants remain at least 6 feet apart in lines and at other times as needed," the guidelines read.
Offerings should be collected in a contact-free manner. "Consider a stationary collection box or electronic methods of collecting regular financial contributions instead of via shared collection trays or baskets," the CDC says.
"Consider whether physical contact (e.g., shaking hands, hugging, or kissing) can be limited among members of the faith community," the guidelines state, adding, "If food is offered at any event, consider pre-packaged options, and avoid buffet or family-style meals if possible."
And the CDC recommends offering people the option of not coming together as a group.
"Consider virtual activities and events in lieu of in-person youth group meetings and religious education classes, as feasible," it suggests, urging religious institutions to "continue to provide congregants with spiritual and emotional care and counseling on a flexible or virtual basis or refer them to other sources for counseling and support if necessary."