Amid the global coronavirus pandemic, many public health experts are calling for the end of the handshake as a social greeting—but such a seismic cultural shift could prove difficult.

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Why we shake hands—and why public health experts say we shouldn't

According to BBC News, the social convention of shaking hands dates back thousands of years, with depictions of people shaking hands in ancient Egypt, Mesopotamia, and Classical Greece. In the United States, the handshake was popularized by the Quakers in the late 17th century, as they believed it was a "more egalitarian" greeting than a bow or a hat tip, Business Insider reports. Experts note that people in earlier times also used the handshake as a sign that they were not carrying a weapon.

But now, Gregory Poland, an infectious disease expert at the Mayo Clinic, says the germs on a person's hand make it a weapon all on its own. "When you extend your hand, you're extending a bioweapon," he said, adding that shaking hands is an "outmoded custom and it has no place in a culture that believes in germ theory."

Other health experts have expressed similar sentiments. For instance, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said, "As a society, just forget about shaking hands." He continued, "We've got to break that custom … [b]ecause as a matter of fact, that is one of the major ways you can transmit a respiratory-borne illness."

And research backs those claims. One group of researchers wrote in the Journal of Dermatological Science, "Hands are like a busy intersection, constantly connecting our microbiome to the microbiomes of other people, places, and things." As such, they are a "critical vector" for transmitting microorganisms, including viruses, the researchers wrote.

"Think about it," Charles Gerba, a microbiologist and public health researcher at the University of Arizona, said. "Every time you touch a surface, you may be picking up … 50% of the organisms on that surface."

Gerba said research he's conducted has shown that it takes four hours for a virus on a doorknob in an office to end up on half of the hands and half the surfaces in that office building, or roughly 90% of the surfaces in a person's house.

"I think we're in a time when we are now going to have to reevaluate a lot of the ways we interact in society," Dan Chonde, a resident physician at Massachusetts General Hospital, said. "As far as cultural norms go, things come and things go. It seems perfectly reasonable that the handshake could definitely be one of them."

Why it could be difficult to ditch the handshake

Getting rid of the handshake could prove difficult because it's a major part of world culture, especially in the world of business, BBC News reports.

"Even though handshakes aren't literally used to ascertain whether or not the other person is holding weapons anymore, they've maintained their signal of showing good intentions," Juliana Schroeder, a professor at the University of California-Berkeley, said. "That's a very important signal in business contexts, where people are often meeting with strangers in highly consequential settings."

Tiziana Casciaro, a professor of organizational behavior at the University of Toronto, said handshaking taps into "a fundamental drive" within humans to establish trust with one another.

It's also difficult to "unlearn a behavior" like shaking hands, Jacqueline Whitmore, an etiquette expert and founder of the Protocol School of Palm Beach, said. "Especially when you've been raised to shake hands your entire life."

But Casciaro noted that the global coronavirus pandemic could make people apprehensive about shaking hands going forward. "We're going to be shell-shocked for a while," she said.

And a poll conducted by Business Insider and Survey Monkey suggests Casciaro may be right. The poll asked respondents, "Given that they can be a vector for transmission of disease, some public health officials have suggested replacing the customary handshake with an alternative greeting. What are your views on this?"

According to Business Insider, 54% of participants responded with "I think we should transition to an alternative greeting," while 36% responded with "I'm not sure," and 11% responded with, "I think we should continue shaking hands as a greeting."

What could replace the handshake?

But if the world ultimately can shake the social convention of the handshake—what could take its place?

Poland suggested a tilt of the head or an elbow bump could serve as alternatives, though he acknowledged that the latter can be awkward.

According to Business Insider, 22% of respondents to its poll suggested a wave could be an appropriate replacement, while about 15% suggested a simple verbal greeting, 14% suggested a nod, and 8% suggested a bow.

Whatever the replacement, nixing handshaking is something society has the ability to do—even if we're not exactly happy about it, Kanina Blanchard, a professor and lecturer in management communications at the University of Western Ontario, said. "[I]f there is a societal need to adapt, we—as human beings—are immensely capable" (Arnett, Boston Globe, 4/28; Younis/Baldwin, Reuters, 4/28; Lufkin, BBC News, 4/13; Perrett, Business Insider, 4/27).