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In this Nov. 13, 2019, file photo, Rafael Nadal, of Spain, uses a towel after he plays a point against Daniil Medvedev, of Russia, during their ATP World Tour singles tennis match at O2 Arena in London.Kirsty Wigglesworth/The Associated Press

No more high-fives, only fist bumps. No more autographs for fans. Cancelled competitions and games played out in empty stadiums. The Tokyo Olympics in doubt. And tennis towels, oh those towels.

The last time you watched a pro tennis match, you likely took little notice of the ball kids who scramble about the court handling the towels that players use to wipe their sweaty bodies between points.

Now, with the world gripped by the global spread of coronavirus, that sweaty towel practice seems glaringly unhygienic. You won’t see it at Indian Wells next week when the unofficial fifth Grand Slam of the tennis calendar opens in the California desert.

On Friday, organizers of the BNP Paribas Open released a long list of proactive measures for the Indian Wells tournament in light of the coronavirus epidemic. Players will grab their own towels off courtside chairs; ball kids, ticket takers and food vendors will wear gloves, and first-aid workers will wear face masks. Fans can access more than 250 hand-sanitizing stations across tournament grounds or request full refunds if they choose not to use their tickets.

This is an early glimpse of the North American sports world figuring out how to run an event while trying not to fuel the spread of coronavirus – a tall task while bringing together hundreds of athletes and staff alongside thousands of fans.

The coming months will see a jam-packed schedule of big events in North American sports, just as the novel coronavirus arrives in cities across the continent, forcing organizers to make some decisions. The flu-like coronavirus originated in China late last year and as of March 6, there were over 100,000 confirmed cases in 90 countries, along with 3,400 deaths. The numbers are currently rising each day.

Event organizers in Europe and Asia have made tough decisions in recent months. Italian soccer matches have been postponed or played with no fans. The PGA Tour Series-China postponed two of its qualifying tournaments, while the LPGA cancelled three events scheduled for Thailand, Singapore and Hainan Island in China. The world indoor track and field championships in China were postponed. At English Premier League soccer games, they’ve temporarily banned on-field handshakes.

In men’s tennis, upcoming ATP Challenger Tour tournaments scheduled for China, South Korea and Spain have been cancelled. Davis Cup ties in Japan and Italy this weekend have no spectators, while China withdrew from its tie. In women’s tennis, the WTA cancelled two tournaments which were scheduled for April in China, while some Fed Cup ties slated for China have been moved to Dubai.

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NHL Commissioner Gary Bettman speaks to the media before Game 1 of the NHL hockey Stanley Cup Final between the St. Louis Blues and the Boston Bruins in Boston on May 27, 2019.Charles Krupa/The Associated Press

The NHL and NBA are hurtling quickly toward the playoffs, while the PGA and LPGA are ramping up for their biggest golf tournaments. March Madness is quickly arriving, with the NCAA’s marquee basketball tournament about to tip off across the United States. Major League Baseball teams are deep into spring training, just weeks from their opening days. Canadian athletes are in the final months of their preparations for this summer’s Olympic and Paralympic Games in Tokyo.

Leagues and sport federations have all rushed out statements stressing their vigilance when it comes to the outbreak. Many of these statements share common traits. The organizations are continually in touch with their local, national and global health experts, and they are communicating the latest precautionary health measures and guidelines with their athletes and staff, including any travel advisories.

The NBA sent its players a memo suggesting that players “fist bump” fans in lieu of a “high five” and avoid items handed to them by fans for autographs like pens, markers, balls or jerseys. One star, Portland Trail Blazers guard CJ McCollum, tweeted to his fans that he will be taking a break from signing autographs, and reminded them about good hand-washing. Other players are concerned about protecting their young children from the coronavirus.

“I’ve got two kids at home so everything is extra scary when things happen like that because [the] first people you think about is old people, babies and sick people,” Toronto Raptors guard Fred VanVleet told Postmedia in San Francisco. “We’re in a weird situation. They’re not canceling any NBA games, unless it gets really, really bad. And we have to travel and things like that so I’m sure we’re all exposed but I don’t really get too worked up about things.”

The outbreak was a topic of discussion at the recent NHL general managers’ meetings. The league has reportedly banned its employees from business travel outside North America and for anyone who does travel outside that restriction, has mandated a two-week quarantine before that person can return to work.

The International Ice Hockey Federation has cancelled four men’s under-18 events and two women’s tournaments, and so far the women’s world championships slated for Halifax next month isn’t one of them. However, a separate women’s hockey showcase event featuring the world’s best female stars – the Dream Gap Tour – has also been impacted. One of the tour events, a three-game showcase in Japan, was scrapped due to the coronavirus.

“It seemed like everything was good to go with the trip, and then things in Japan changed so rapidly,” said Hockey Hall of Famer Jayna Hefford, head of operations for the Professional Women’s Hockey Players Association, which is running the Dream Gap Tour. “So we got a first-hand look at how fast the coronavirus situation is evolving and how important decisions need to be made quickly.”

Hefford described a time in which her group monitored daily updates from government health experts in order to help make decisions. It’s a process that many sports organizers are experiencing right now, including those who are preparing for the Olympics and Paralympics.

Swimming Canada decided to temporarily limit travel for its national teams, keeping them in Canada and mainland United States, where they could get home by ground in an absolute pinch if air travel became restricted. That meant cancelling a trip for its open-water swimmers to train in Israel. The governing body said it will re-evaluate that policy after the Canadian Olympic trials in Toronto later this month.

“We need to focus on what we know, and that’s that the [International Olympic Committee and World Para Swimming] are going to continue with the Games preparation and so shall we until we hear otherwise,” Ahmed El-Awadi, chief executive officer of Swimming Canada. “We will adapt as we get information from our credible health authorities. Our coaches have kept our athletes focused on training. We had the Zika scare before Rio. At this level, our athletes are quite good at adapting to a bit of chaos.”

Many athletes slated to compete in Tokyo are wondering what will become of some international competitions scheduled on their calendars in preparation for the Games.

“I am supposed to be in California, Louisiana, Italy and Switzerland in the coming months,” said Marissa Papaconstantinou, a Paralympic sprinter from Toronto. “In Parasport, we have so few opportunities to compete internationally and show the world what we can do, so it’s devastating to think of any events being cancelled. You want to stay informed about the latest updates, but at the same time, you just want to put it out of your mind and focus on training.”

Of course, young, healthy people with no pre-existing medical conditions are not among those most at risk of succumbing to symptoms of the coronavirus. Elite athletes, supervised by team doctors, are often known for their diligence with germs.

“I’ve been around lots of athletes over the years, and I’ve never seen so much hand sanitizing,” said Brian Levine, the founder and president of Envision Sports & Entertainment Inc., who works with pro and Olympic athletes.

Still, the gatherings of large groups of people at large sporting events worries many at time when social distancing has become the order of the day.

Dr. Isaac Bogoch is one of the experts in infectious diseases who is helping to provide information that will help decision-makers. He is from Toronto General Hospital’s Research Institute and is currently travelling internationally to help advise health authorities and air travel groups.

“It’s easy to say we’re cancelling a game or event, but we have to ask – will it truly, significantly reduce virus transmission in community settings, or are we just doing it because other people have done it?” Bogoch said by phone while travelling from Singapore to Amsterdam. “I don’t stand strongly on one side or the other when it comes to cancelling large sporting events, but it is worthwhile to study the true impact of the cancellations on transmission dynamics of the virus.

"You can use mathematical modelling and case studies. This is not going to be the last time we see an epidemic like this so we should try to mitigate the damage of this epidemic while also learning everything we can from it.”

Bogoch said you can’t apply a one-size-fits-all solution to this outbreak. What works to contain it in one city may not work in another. He said researchers around the world have been very transparent about sharing their data with the World Health Organization.

“We should be really thoughtful and rely on data and evidence to drive decisions, and also take in the meaningful suggestions from many stakeholders. These decisions require careful thought. This can be shared decision-making that involves medical and public health expertise, citizen engagement, and the teams involved,” Bogoch said. “What is true today may be very different in the days ahead. We’re dealing with shifting goalposts every day as this epidemic evolves.”