Our social lives are filled with ritualistic touching: from hugs to high fives to pinky-swears. These acts of interpersonal contact create feelings of connection between people—both literally and psychologically—but they also give pathogens an efficient way to move from person to person.
In this time of social distancing, what kinds of greetings should we use? What makes one kind of greeting more infectious than another? What actions can we take to feel close, even when we must keep our distance? Let's take a quick tour of our choices.
The Basic Handshake (DON'T DO IT!) This is the main culprit. The virus moves from someone's hand to your hand. You touch your face. You become infected. We must break this habit.
The Botswana Handshake Many countries in Africa have elaborate local handshakes such as the Liberian Snap Handshake (in which the participants snap each other's fingers!) or the Botswana Handshake, partially pictured here, where the hands meet in a high-contact grip. Is a stronger handshake any worse than a regular one? The answer is yes: A strong-gripped handshake transfers about twice as much bacteria per area of contact as a moderate handshake. (You can read about this research here. They literally gave people gloves coated in E. coli bacteria and had them shake hands with people wearing sterile gloves, and measured the amount of transmission.)
The High Five The same research shows that a high five transfers only half as many germs as a normal handshake. That's a big improvement! It may feel like high fives has been around forever, but in fact they only appeared in the late '70s or early '80s. The practice seems to have evolved from the more conventional torso-level five, which has been a part of African American culture since at least the 1920s.
The Fist Bump This greeting has a variety of origin stories. Some say it evolved from the way boxers touch gloves before a match. Others say it emerged from the world of professional darts, where players want to avoid shaking hands with someone holding a bunch of pointy projectiles. The study mentioned above found that a fist bump is the most hygienic contact hand greeting of all, transferring only about 10% of the germs you'd get from a standard handshake. As the authors conclude, ". . .we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake."
The Elbow Bump United States Surgeon General Jerome Adams is recommending the elbow bump as a handshake alternative. The elbow bump had an initial rise in popularity in the 60s at the Kalaupapa Leprosy Settlement on the Hawaiian island of Moloka'i. To avoid contagion, elbow bumps became the preferred way for greeting settlers with leprosy. The elbow bump certainly cuts down on infection from pathogens, given that your elbows don't get anywhere near your face. But then again, aren't we supposed to coughing into our elbows?
Hongi Face-to-face contact greetings are common around the world. One example is hongi, the touching of noses and foreheads by the Māori people of New Zealand. This is similar to the Inuit kunik (or "Eskimo kiss") and the touching of noses common in Gulf Arab states. Throughout Europe, it is customary to greet another person with some number of air kisses on their cheeks (la bise in French). It may seem that such close contact is the worst thing you could do right now. But scientific studies indicate that even passionate kissing transfers fewer germs than a handshake. Your hands come in contact with many more surfaces than your face does, and lack the antibacterial effects of saliva. Such close contact is still to be avoided, but the fact that it's safer than a handshake should at least alert us to the fact that our hands really are pretty gross.
The Wuhan Shake Viral videos from China, Iran, and Lebanon show people touching feet (sometimes while making kissing noises), now known as the "Wuhan shake." Like the elbow bump, this greeting moves the point of contact away from the hands and face, lowering the risk of contamination. It also presents rich opportunities for embellishment.
The Klutz® Ankle Shake For a somewhat more whimsical podiatric greeting, you can attempt the famous Klutz® Ankle Shake: 1. Approach as if for a normal handshake. 2. Reach for the hand . . . but miss on the outside. 3. Lean over, grab the person's ankle, and shake vigorously. Simultaneously, lift your own ankle up so that they may do the same. A bit overly performative, perhaps, but the Klutz® Ankle Shake provides the gratification of shaking part of another person's body while limiting transmission (you're unlikely to touch your face with your ankle).
Air Hug Noncontact greetings are probably the way to go for a while. Six feet is a safe distance from airborne nasal droplets from an infected person. Performed from this distance, the air hug is expressed with wide, curving arms that squeeze inward abruptly once or twice, and is perhaps accompanied by the exclamation, "air hug!" This greeting is also sometimes called the "fish hug" or the "salmon hug," as the two parties end up looking like two fish affectionately waving their flippers at one another.
V for Victory Flashing hand signs is a safe and highly customizable from of greeting. The "V for Victory" sign has a long history, possibly originating as a hand sign made by English archers in the 15th century to show their battle-readiness (you only need those two fingers to shoot an arrow). The sign was used extensively in America during World War II and was then co-opted by the antiwar movement in the 1960s to signify peace. Now it's a popular way to signal levity when taking a selfie.
Namaste An almost universally recognized gesture of polite salutation is to place your hands at chest level, with palms together and fingers pointing up. This sign goes by many names. It's most commonly referred to as the Hindu Namaste gesture, or more formally as the Anjali mudra. In Thailand it is called wai, in Cambodia, sampeah, and in Japanese Zen Buddhism, gassho.
Finger Heart This gesture, in which the tips of the thumb and forefinger form the bumps of a tiny heart, comes from South Korea, where it was first popularized by K-pop stars. The heart is supposedly small enough to not carry any overt romantic connotations. This sign is appropriate even between casual friends.
Shaka From Hawaiian surf culture we get the shaka, or "hang loose" sign. Extend your thumb and pinky and rotate your hand back and forth for emphasis. This sign carries strong postive connotations of friendship, solidarity, and a laid-back attitude.
Tibetan Tongue Greeting Here's a fun one: the Tibetan custom of sticking out one's tongue to say hello. There are a few competing origin stories for this custom, all involving the idea that the practice of certain black magic actually colors the practioner's tongue black. By revealing a conventionally colored tongue, your good intentions are established.
These are unusual times. While a natural disaster or terrorist attack becomes an occasion for all of us to draw together, the coronavirus pandemic requires us to isolate and stay apart. It is important to exercise maximum caution to protect ourselves and others, but it's also important to remember that human connection is indispensible for our collective resilience. As Rabbi Yosef Kanefsky wrote recently, "Every hand that we don’t shake must become a phone call that we place. Every embrace that we avoid must become a verbal expression of warmth and concern. Every inch and every foot that we physically place between ourselves and another must become a thought as to how we might be of help to that other, should the need arise."