The handshake went on hiatus during the pandemic. Some doctors hope it's gone for good

As we emerge from the pandemic, we're starting to see the return of an age-old ritual: the handshake.

Many of us went a year or more without clasping someone else's hands. But as vaccination rates go up and social distancing restrictions fall, we're starting to press the flesh again.

"I am shaking people's hands when they offer it to me," said Sheila Nezhad, a candidate for mayor of Minneapolis. Nezhad, who recently started in-person campaigning, has been exchanging fist bumps, elbow bumps and the traditional grip-and-grin, even though it was little disorienting at first to put 'er there.

"It kind of felt like getting back on the bike after having not ridden one for a while," she said.

Not everyone is happy that the handshake is making its way back. Though it's a deeply ingrained way of expressing friendship and respect, some medical experts wish it were gone for good.

"I don't think we should ever shake hands again, to be honest with you," said White House health adviser Anthony Fauci back in April 2020. "Not only would it be good to prevent coronavirus disease, it probably would decrease instances of influenza dramatically in this country."

"It's never been safe," said Dr. Gregory Poland, a Mayo Clinic physician and professor specializing in infectious diseases and vaccines.

Handshaking carries the risk of transmitting a host of undesirable conditions, including norovirus, food poisoning and "hand-borne transmission of fecal bacteria," Poland said.

"We're not talking about a minor issue," he said. "Would you lick someone's hand?"

Handshaking may have started as an ancient custom to demonstrate to a stranger that you had no weapon in your hand. But "you are, in fact, bearing at some level, a bioweapon" on your unwashed hand, Poland said.

"I'm not going to shake hands," said Dr. Mark Sklansky, a professor and pediatric cardiologist at UCLA. "I think it's really a bad habit."

Sklansky campaigned against disease-spreading handshakes before COVID-19, writing articles like "Banning the Handshake From the Health Care Setting," published by JAMA in 2014.

More recently he's been writing songs for music videos, urging people not to shake on it. (Sample lyric: "Dear kindhearted friend, I know you mean well extending your hand when we meet. But let me be open. Please listen to me. I'd prefer not to shake when we greet.")

We all seemed to agree to put a pause on handshaking during COVID-19.

"It's unfortunate that we needed a pandemic to shake some sense into people on how disease is transmitted," said Sklansky, who's worried that the opportunity to kill the handshake is slipping through our fingers.

Recently, he's been at social gatherings where "sure enough, people reach out to shake my hand." (He won't.)

Even if there weren't a pandemic or colds or stomach flu to worry about, handshakes also carry the risk of a social gaffe.

Guides to giving a proper handshake make the maneuver sound as hard as mastering your golf stroke. Your grip should be firm. But not too firm. Don't swing your hand too vigorously. Don't offer a sweaty hand. No more than three pumps.

Get it wrong, and you could end up like Vice President Kamala Harris, who got grief for appearing to wipe her hand after shaking hands with South Korean President Moon Jae-in at the White House last month.

So much can go wrong with a handshake. You have to wonder why we bother.

Clasping or shaking hands as a symbol of friendship, trust and hospitality was practiced by Babylonian kings and ancient Romans and promoted by 18th-century Quakers as a more egalitarian greeting than bowing.

It's become an international ritual of agreement, respect and congratulations in modern business, politics and sports.

"A handshake has always been our personal olive branch," said Maralee McKee, founder of the Orlando-based Etiquette School of America.

While it's clearly culturally ingrained, David Givens, an anthropologist and director of the Center for Nonverbal Studies in Spokane, Wash., said our desire to shake on it may go deeper than protocol.

Our fellow primates — chimpanzees and gorillas — also reach out and touch their companions' palms and fingertips. The surface of the hand is rich with nerve endings, making it "an information-gathering organ," Givens said.

The handshake is literally the personal touch, formal and intimate at the same time.

Scientists studying "social chemosignaling" are trying to determine if shaking hands is one way in which we send subliminal chemical signals to each other, signals that help shape our behavior.

But right now, we are in a socially awkward time of handshake uncertainty, when some people are comfortable shaking hands and some are not.

"It's about 50-50, maybe 55-45, with 55 being for handshaking," McKee said.

In other words, you have to be on your toes socially to avoid making someone uncomfortable by offering a handshake or offending someone by refusing to accept one.

St. Paul-based etiquette expert Juliet Mitchell said that while the pandemic "didn't kill the handshake, we've got to acknowledge not everything is back to business as usual."

If you're not comfortable accepting an offered handshake, McKee and Mitchell advise being ready to respond with a polite deferral.

Instead of recoiling, keep your hands to your side, maintain eye contact, smile, nod or slightly bow while saying something gracious like, "I'm currently not shaking hands, but it's so very nice to meet you."

Then just move on, and don't over-apologize, Mitchell said.

If you want, you can offer an alternative gesture of greeting, which could range from a fist bump, an elbow bump, a namaste gesture or the wai gesture of Thailand. Movie fans could consider a Wakanda forever salute or a Vulcan "live long and prosper" greeting.

McKee advocates what she calls the social distance greeting, which involves placing the palm of your right hand on your chest slightly above your heart with your fingertips touching your collar bone while smiling and looking the other person in the eye.

These hands-free alternatives are almost certainly likely to be more hygienic than the traditional handshake. Experiments have shown that handshakes transfer more bacteria than fist bumps or even high-fives, and that the longer and firmer the handshake, the more bugs are exchanged.

Sklansky is convinced that even long-held cultural norms can change over time if we realize how unhealthy they are. (He points out that smoking used to be a common practice among doctors.)

"It's not an easy task" to stop handshaking, he said. "But I'm not going to give up."

For his part, Givens said that in the future, we may find polite ways to apply Purell after meeting someone, but he's confident we'll keep shaking hands.

"A lot of people are saying 'good riddance.' But I don't think it's going to completely die out," he said.

Richard Chin • 612-673-1775