DES MOINES, Iowa — When Zion Lutheran Church in Oelwein again closed its sanctuary to in-person services last Sunday, few members questioned the move: COVID-19 cases in rural northeast Iowa’s Fayette County have nearly quadrupled in a month.

Their acceptance was in sharp contrast to the reaction in March, when Iowa Gov. Kim Reynolds temporarily shut down in-person religious services across the state during the coronavirus’ initial spread.

At that point, Fayette County had few coronavirus cases, said Zion Pastor Josh Schunk, and “people thought it wasn’t that big of a deal” — possibly like getting a cold. Other rural areas, too, largely escaped widespread outbreaks early in the pandemic, except in some towns with meatpacking plants, where the disease spread among workers on crowded processing lines.

But today, the congregation has 14 members who have tested positive for COVID-19, although they weren’t exposed at church, Schunk told the Des Moines Register.

“Now people understand these numbers are big and scary. And we need to be careful,” he said, adding, “I don’t have a day that goes by when I don’t get a call from somebody saying they have COVID.”

Almost everyone now knows someone with the virus, and “it changes their perspective,” said Schunk, who has taken to offering online services and a parking-lot service through a low-powered FM station so congregants can remain in their cars.

When Iowa Gov. Kim Reynolds last week announced new coronavirus restrictions for Iowans, including broad mask-wearing requirements and restrictions on the size of gatherings, she excluded religious activities.

But with the number of coronavirus cases exploding across Iowa, especially in rural areas, many churches have voluntarily ramped up restrictions. They range from mandating that people wear masks to no longer allowing singing during services to moving services online.

From the Missouri to the Mississippi rivers, rural Iowa churches are canceling Advent suppers and Christmas concerts and pageants. Others will require reservations for popular holiday services or add more, but smaller, services to ensure parishioners can safely maintain social distance.

Pastors say restricted access to services and other church activities has been especially hard for rural parishioners. Among the small towns and farmlands that make up so much of Iowa, churches are for many people the cornerstone of not only their spiritual life but also their social life. Nearly half of rural Midwesterners say they attend services regularly, data from the Gallup polling firm show.

Schunk said the pandemic has isolated parishioners.

“We’ve made the lonely even lonelier,” said Schunk, whose pastoral assistant each week calls elderly and disabled parishioners who are unable to leave home.

“You want to reach out and hug them and you can’t,” he said, adding that he’s been able to conduct nursing home services only twice since March. “We’re called to work with people, and we can’t.”

In Perry, Father Luis Mejia said that even with only 40 percent of the congregation back inside St. Patrick’s Catholic Church, he’s added a weekend service so families have enough space to maintain social distance. He’ll add masses for highly attended Christmas services as well.

“Most people wear their masks,” he said. “They understand we’re in the middle of a pandemic.”

The changes are concrete evidence of a now-inescapable reality: Nowhere is safe from the pandemic.

“Rural areas are where we’re seeing the biggest surge,” based on the proportion of the population testing positive, said Nicole Novak, an assistant research scientist at the University of Iowa College of Public Health.

Eighty percent of Iowa’s rural counties exceed what’s considered a high prevalence of COVID-19, the disease caused by the coronavirus, Novak said. “That’s concerning because the rate of increase is still accelerating,” she said.

Iowa’s rural population is more at risk of serious illness from the coronavirus than people in cities, given the greater percentage of elderly residents, people with chronic health conditions, such as heart disease and diabetes, and a greater proportion of population without health insurance, said David Peters, an Iowa State University associate professor of rural sociology.

With COVID cases climbing across the state, Bishop William Joensen last week told about 130,000 Catholic parishioners across 23 counties in the Des Moines diocese they must wear masks when they attend mass and other church-related activities.

Joensen said priests in the diocese’s 80 parishes will appeal to parishioners’ “better angels,” encouraging compliance through a message of charity for others. “Wearing a mask shows our love for others by protecting them,” the diocese says on its website.

“Some people see it as an infringement on their own personal prerogative,” Joensen said. “We try to depoliticize it. But for some, it’s part of the equation.”

Some denominations leave it to local congregations and pastors to decide how best to respond to the coronavirus.

“We’ve balanced what is permissible and what is wise, even though we technically don’t have any legal restrictions,” said the Rev. Paul Schulz, who leads Trinity Lutheran Church, a Missouri synod church in western Iowa.

“That doesn’t mean we should use that freedom,” said Schulz, whose congregation is encouraged to wear masks during services.

Like Schunk in Oelwein, he also broadcasts the service through a low-powered FM station for parishioners who stay in their cars in the parking lot to listen.

“We’re hearing from more and more congregations that they’re going to all virtual or parking lot church or one of the many creative variations. But they’re mostly suspending in-person worship,” said the Rev. Mark Anderson, an assistant to the Evangelical Lutheran Church in America’s acting bishop for the Northeastern Iowa Synod.

“It’s just not that safe,” said Anderson, adding that the church he attends in Waverly has remained virtual since March, sending wine — actually grape juice — and wafers for communion to parishioners through the mail.

The need to stream services online has pushed churches to invest in new technology and has broadened who participates in services, Anderson said. Some pastors offer podcasts and daily devotions online.

“In some ways, this plague has propelled church into the 21st century,” he said.

“When we look at the analytics, we see that more people are attending, and they’re from all over” the country and world, Anderson said. “You can go to church almost anywhere.”

The Davenport and Sioux City dioceses began requiring masks in June, when churches started reopening. And Dubuque Archbishop Michael Jackels preaches strongly about the need to wear a mask, said Deacon John Robbins. Parishioners “haven’t been left guessing about what the archbishop is asking,” Robbins said.

But there are pockets of resistance. Because the virus took a while to reach rural places in Iowa and elsewhere, Peters said, people might have become skeptical about the coronavirus’ impact, making them discount guidance about social distancing or wearing masks.

“People thought it had bypassed them,” he said.

A bitter presidential election also has politicized wearing a mask, he said. President Donald Trump, despite having had COVID-19 himself, has sent mixed messages about the effectiveness of masks and mocked President-elect Joe Biden for wearing one.

Anderson, an assistant to the acting Northeast Iowa ELCA bishop, agreed.

“God created us to be part of communities and families,” Anderson said. “We’re not meant to be alone like this. I think all of Iowa will rejoice (when) we can again have a potluck.”