Has Covid-19 ended the handshake for good?

Modern-day science shows that close-contact greetings can pass on pathogens - will we ever get them back?

An Indian doctor wearing PPE bumps fists with a patient inside a Covid-19 care centre and isolation ward facility near a Hospital in New Delhi, India. The fist bump has become the norm during the pandemic. EPA

Britain's Prime Minister Boris Johnson greets a member of vaccination staff with an elbow bump during a visit to a Covid-19 vaccine centre in Northampton. The elbow bump is another trend to emerge during the pandemic. Getty Images

US President Joe Biden shakes hands with French President Emmanuel Macron during a meeting at La Villa Bonaparte in Rome, in October 2021. The handshake was starting to re-emerge as form of greeting. AP

The 2,800-year-old stone relief held at The Iraq Museum in Baghdad. Assyrian King Shalmaneser III is seen shaking hands with Babylon’s King Marduk-zakir-shumi. Osama Shukir Muhammed Amin / Wikimedia Commons

People hug at Ezeiza International Airport, in Buenos Aires, Argentina. Reuters

US Secretary of State Mike Pompeo says goodbye with a kiss on both cheeks to Saudi Minister of State for Foreign Affairs Adel al Jubeir, as Mr Pompeo departs Jeddah before the pandemic. Reuters

In a beautiful 2,800-year-old stone relief held at the Iraq Museum in Baghdad, the Assyrian King Shalmaneser III is seen shaking hands with Babylon’s King Marduk-zakir-shumi I.

Originating from the ancient city of Nimrud, south of Mosul, as well as the incredible craftsmanship of the time, this depiction of two Mesopotamian leaders demonstrates the long history of the handshake.

Artefacts and literature left behind by Ancient Greece and Rome suggest that in their cultures too, people clasped hands to cement relationships.

Possibly originating to show that no one was carrying weapons, the handshake is thought to have been revived in the 1600s by the Quakers religious group.

If you have groups of people greeting each other with handshakes and you opt out, there’s negative social feedback, even if no one says anything

Prof Cristine Legare,
The University of Texas at Austin

When the coronavirus swept across the globe two years ago, the continued use of this gesture — common in many but not all cultures — was called into question.

Indeed, in April 2020, Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, told a podcast that he did not think that people “should ever shake hands again”, saying that staying apart would prevent the spread of influenza, as well as Covid-19.

“As a society, just forget about shaking hands. We don’t need to shake hands. We’ve got to break that custom,” he said in another interview at the time.

Today, with nearly two-thirds of people in the world at least partially vaccinated against Covid-19, should proffering a hand — or even a cheek to be kissed — still be considered a faux pas?

“Now it’s not the behaviour people had in April 2020, when everybody was panicking. We’ve seen behaviour to some extent return to normal,” says Prof Marc Oliver Rieger of the University of Trier in Germany, who in 2020 surveyed the public’s views and co-wrote a study titled, Kisses, Handshakes, Covid-19 — Will the Pandemic Change us For Ever?

Cameron Young, left, fist-bumps Joaquin Niemann, of Chile, after hitting in for birdie on the 15th hole during the final round of the Genesis Invitational golf tournament at Riviera Country Club, Sunday, Feb. 20, 2022, in the Pacific Palisades area of Los Angeles. Photo: AP

Although people may have become more relaxed about social distancing as time has gone on, and countries have removed Covid-related restrictions, history suggests that long-term changes to social greetings to prevent disease can happen.

Lessons from history

King Henry VI of England banned cheek kissing in 1439, and the practice reportedly did not become commonplace again for centuries.

In the previous century, the Black Death had ravaged populations in Europe, Asia and North Africa, so his concerns that kissing spread disease may not have been misplaced.

Modern-day science shows that close-contact greetings can pass on pathogens.

Kissing can spread the Epstein-Barr virus, which causes mononucleosis or glandular fever, notes Dr Richard Watkins, an infectious disease physician and professor of medicine at the Northeast Ohio Medical University in the US.

As with kissing, research shows that shaking hands can spread disease.

In a 2013 paper in The Journal of Hospital Infection, researchers at West Virginia University in the US described handshaking as “a known vector” for transmission of bacteria. The researchers said that the fist bump was safer.

“We have determined that implementing the fist bump in the healthcare setting may further reduce bacterial transmission between healthcare providers by reducing contact time and total surface area exposed when compared with the standard handshake,” they wrote.

Today, Dr Watkins advises people to persist with social distancing, including not shaking hands, to avoid the spread of pathogens such as Sars-CoV-2.

“I recommend people continue to use alternative forms of greeting. A smile and a wave are good ways to convey that you are happy to see someone,” he says.

But as the pandemic has often demonstrated, science and human nature do not always move in lockstep.

The issue of gesture politics

Prof Rieger notes that in places where the pandemic has become highly politicised, some people have rejected measures such as vaccination, mask-wearing and other government instructions.

“[Some people think that] you keep shaking hands to show you’re not one of those sheep that follows the government,” he says.

Aside from such politicised approaches, psychologists say that for social animals like humans, touch and all that goes with it is important.

French President Emmanuel Macron and European Commission President Ursula von der Leyen bump fists. Photo: Reuters

“A handshake is typically accompanied by eye contact and recognition. The physical touch is a form of connection,” says Prof Cristine Legare, professor of psychology and the director of the Centre for Applied Cognitive Science at The University of Texas at Austin.

“There’s trustworthiness: someone who provides a firm handshake, who looks you in the eye, signals: ‘I’m attending to you. You can trust me. I’m invested in this.’”

This ties in with studies that indicate that people are more likely to do business with people who they have shaken hands with.

Humans, she says, need close contact with others “psychologically, even physiologically” and it is “a huge part of our physical and emotional well-being”.

“Long-term social distancing I think it’s unsustainable,” she says. “I don’t think people can tolerate it any more, now we’re two years into it. The costs have been so high that even when there’s still some risk, I think the costs of continuing to distance are intolerable for most people.”

Although people can “self-select out” by living by themselves and working remotely, she thinks just “a tiny proportion” will go against a return to the social norms such as shaking hands. Even those who would prefer not to press the flesh again may find it difficult to resist social pressure.

“If you have groups of people greeting each other with handshakes and you opt out, there’s negative social feedback, even if no one says anything,” Prof Legare says.

Declining to shake hands, analysts have noted, may also be seen as passing judgment on others who proffer their hand in greeting.

But Prof Rieger thinks things have changed and that now “it’s socially acceptable to forgo some greetings in certain circumstances”. In healthcare, for example, long-term efforts to reduce handshaking may have been helped by the pandemic.

“Now it’s much easier to say, ‘In this hospital or in this physician[‘s clinic], we don’t shake hands. We smile and say hello,’” he says.

Just as the long-term effects of the pandemic on our social habits may vary according to the social or professional setting, so they may not be consistent from one country to the next.

Prof Rieger says that before the pandemic, kissing as a greeting had become popular among young women in Germany, but such less-established practices may never return.

“I think these really new ways of behaving that are not established in the whole population will have the hardest time to survive. It’s easiest to drop them,” he says.

By contrast, in countries such as France, where the greeting has a long tradition, he suggests it is less likely to disappear because of the upheaval of the past two years. The kiss is also, of course, an established greeting in parts of the Middle East.

As familiar forms of greeting return, at least in some circumstances, so more recent arrivals like the fist or elbow bump introduced in their place may fade away.

“In five years, people will think it’s funny if someone is doing it: ‘We just don’t have any tradition [of this]. It’s weird,’” Prof Rieger says.