Has COVID-19 Killed the Handshake?

People have been shaking hands at least as far back as the ninth century B.C.E. based on an ancient relief showing Assyrian King Shalmaneser III pressing palms with a Babylonian king to seal an alliance. Around that time, Homer also described several handshakes in both the "Iliad" and "Odyssey."

A few centuries later, during the fifth century B.C.E., Greeks used hand shaking as sort of a "I come in peace" gesture. Holding out an empty hand showed it was free of weapons. And the whole up-and-down pumping motion was supposedly used to dislodge any daggers that may be hiding up one's sleeve.

The act of handshaking in America was believed to have been popularized in the 18th century by the Quakers, who found the practice to be a far more democratic form of greeting than the more stuffy bow or curtsy.

The well intentioned handshake was still thought to be an innocuous greeting well into the 19th century despite a rising awareness among surgeons in the medical community who discovered that something as simple as washing their hands cut down on the number of patient infections. By the late 1870s, surgeons were regularly scrubbing their hands to rid themselves of disease-spreading bacteria, but the practice of handshaking continued.

That is, until COVID-19 made social distancing a "thing."

The average person's hand carries about 150 different species of bacteria, according to a University of Colorado at Boulder study — at levels similar to or up to three times higher than the bacteria found colonizing in other parts of the body, including the esophagus, mouth and lower intestines. What's the most common way to spread those hand germs? Through direct contact, says the Centers for Disease Control and Prevention (CDC).

A study published October 2020, in the journal Clinical Infectious Diseases found that the coronavirus, which causes COVID-19, can survive on human skin for nine hours, and up to 11 hours when mixed with mucus from coughs or sneezes — significantly longer than the flu virus, which lingers on skin about two hours, max.

Regular handwashing is recommended, but even that doesn't kill all the bacteria that takes up residence on our hands. When it comes to a highly contagious bug such as COVID-19, Fauci reiterated during an April 2020 interview with Sinclair Broadcast Group, "As a society, just forget about shaking hands. ... We've got to break that custom because, as a matter of fact, that is really one of the major ways that you can transmit a respiratory illness."

"To be honest, my personal view is that handshaking is a ritual, a cultural norm that serves no functional purpose," Joshua Klapow, Ph.D., a clinical psychologist affiliated with the University of Alabama at Birmingham's School of Public Health, says via email. "Long before COVID, every cold and flu season I was aware that every hand I shook meant I needed to be aware of infection of any kind that could be transmitted. During COVID, there was no logical need, in my view, to add the risk to engage in a ritual."

Apparently, a lot of people share that view. According to a 2020 survey of 23,000 U.S. adults by global public opinion and data company YouGov, fewer than half of Americans say they will go back to shaking hands after COVID-19 dies down.

"We thrive on tradition. It is a way that we hold the past in our present. It allows us to know that things remain the same," Klapow says. "At the same time, something like a handshake may have to evolve into something else."

That's cool with folks, too. According to YouGov survey, 62 percent said they'd opt to wave instead, 55 percent said they'd be good with a nod. Only a quarter said they'd be willing to get close enough to elbow bump.

"There are really two categories of people when it comes to the perceptions around handshaking," Klapow explains. "The first are those who look at the prevention of the behavior over the last year and, coupled with the known spread of infection in general with handshaking, are questioning the need for it moving forward. They look at it as if to say, "Why are we actually doing this and what benefit does it bring?'

"The second are those who see handshaking as a unique part of our culture, as something that needs to return because it signifies a return to normal. They may respect the moratorium on it now but being able to shake hands again means we are 'back,'" he says. "In both cases, it has made us look at the behavior itself much more closely than we ever have before."

The key to mitigating any hurt feelings or presumptions of rudeness for refusing to shake someone's hand, Klapow says, is voicing your intentions. Be kind and compassionate, and come right out and say, "I'm not shaking your hand just to be careful, but it is a pleasure to meet you."

"Anyone who is offended by not having their hand shaken during a pandemic," Klapow says, "has their priorities a bit out of order."