Are We Losing Touch with the Handshake?

As we learn more about the epidemiology of COVID-19, it appears that the main source of transmission is through virus-carrying droplets and airborne aerosols. However, direct person-to-person contact is also thought to play a role, which has led to recommendations for masking, social distancing, and hand hygiene. These recommendations are having a major impact on human behavior and threaten to relegate the ubiquitous handshake to the waste (or hand) basket of history.

Shaking hands has a long history as one of the most recognized forms of non-verbal human communication, probably first recorded in the 9^th century BCE on a relief showing a handshake between an Assyrian king and a Babylonian ruler. As far back as the 5^th century BCE, in ancient Greece, the handshake was a symbol of peace, friendship, and loyalty and was described by Homer several times in the Iliad and Odyssey. In medieval Europe it was thought to be used to show that neither person was carrying a weapon or to shake loose a weapon concealed up a sleeve. The use of the handshake as an everyday greeting is a more modern phenomenon, which may have been popularized by 17^th century Quakers as an egalitarian alternative to bowing or tipping the hat. By the 1800s, etiquette manuals included guidelines for the proper handshaking technique.

Handshaking usually involves the right hand, related to the fact that we live in a right-hand-dominant society and that in some cultures the left hand is used for ritual washing (ablution) and for bathroom hygiene. There are many variations to the “typical” handshake, including weak versus strong, brief versus extended, and a left-handed shake as practiced by the Boy Scouts. There are also numerous culturally-dictated alternatives such as a kiss on each cheek, the Hindu namaste gesture, bowing, fist bumping, the hand hug, high five, the “broshake” of interlocking thumbs, smile, wave, palm touch, chin nod, and the recently popular elbow bump. In Thailand, hand shaking is considered rude, and among Orthodox Jews and Muslims (with the exception of Turkey), handshakes between men and women are pretty much forbidden. Some people have been known to sniff their hand after a handshake leading to speculation that a handshake may unconsciously be used to detect chemical signals, possibly as a means of communication.

Psychologists have had a field day analyzing the meaning of different handshake styles as they may provide more information to others than you think. People may signal their status by variations, such as clasping their companion’s hand with both of theirs, putting a hand on the other person’s arm or shoulder or holding on for a few extra seconds. The palm position may also be revealing. A downward-facing palm is considered dominant, an upward-facing palm as submissive and side-by-side palms as neutral. A study from the University of Alabama found that those with a firm handshake tend to be more extroverted and less neurotic and shy compared to those with a less firm or “dead fish” handshake. Although the handshake seems to be mostly a male thing, women in modern cultures have generally adopted it as well.

In the Guinness Book of World Records, the most handshakes by one person in one day is 19,500, and the record for the longest duration handshake is just over 33 hours, set in Times Square in 2011. There have been a number of famous photo-op handshakes, including Ulysses S. Grant and Robert E. Lee; Adolph Hitler and Neville Chamberlain; Harry Truman, Winston Churchill, and Joseph Stalin; Ronald Reagan and Mikhail Gorbachev; and Yitzhak Rabin and Yasser Arafat. The most politicized handshake in recent times was the prolonged white-knuckle power or alpha handshake between Presidents Donald Trump and Emmanuel Macron prior to a 2017 NATO meeting.

There is ample evidence that handshakes can transmit bacteria, including potential pathogens – and with much higher transmission rates compared to a high-five or a fist bump. The same may be true for viruses. We are all familiar with the emphasis on hand hygiene during medical encounters dating back to before COVID-19. During the 2009 swine flu pandemic, there were calls to short-circuit the handshake, but it came roaring back. This time may be different. According to advice from Dr. Anthony Fauci of the National Institutes of Health, “I don’t think we should ever shake hands again, to be honest with you. Not only would it be good to prevent Coronavirus disease; it probably would decrease instances of influenza dramatically in this country.” There is evidence that we are losing touch with the handshake, which, after a 3,000-year run, may finally be heading toward extinction.