Sat | Jun 6, 2020

Michael Abrahams | Handshaking … a great way to spread disease

Published:Tuesday | May 19, 2020 | 12:12 AM

I HAVE been looking after her since she was a teenager. Now, she is not only an adult, but a married woman preparing to become a mother. As I greeted her in the waiting area of my office, she turned to the young man to her right and gleefully said, “Dr Abrahams, I would like you to meet my husband.” Although his face was partially covered, as is the norm these days, I could sense the smile behind the mask. I approached him while extending my right hand, as he did the same, but before contact could be made, I suddenly withdrew my outstretched hand and exclaimed, “Sorry. I forgot that we are not supposed to do that!” and converted the handshake to an elbow bump, as we both laughed at our forgetfulness.

Our mutual lapse in judgement is understandable. Shaking hands has not only been a part of our lives for centuries, but the benefits of a good handshake have been well researched and documented. For example, summarising the results of a 2008 study he led, Greg Stewart, a University of Iowa professor of management and entrepreneurship, found that in job interviews, “people who shake hands well are more likely to get job offers”.

“Our evidence would suggest that people who shake hands well are socially adept,” he said. “They know how to operate well in social situations. So, the handshake has traditionally been a cue of social awareness and knowing how to interact properly with people.”

More recently, a study published in the Journal of Personality and Social Psychology in 2018 found that people who shake hands before beginning negotiations achieve “better joint outcomes,” while executives who shake hands before “antagonistic” talks are “less likely to lie about self-benefiting information, increasing cooperation even to their own detriment”.

Throughout history, handshakes have marked the end of wars, the beginning of peace talks, and the launch of major business deals, among other events of significance. A handshake has been deemed to be of such importance that after injuring his finger, a French consul was awarded $60,000 in damages from a trucking company in 1959 after proving that handshaking was integral to his career as a diplomat. The insult of refusing a handshake is also well recognised, such as Hitler declining to shake Jesse Owens’ hand at the 1936 Olympics.

However, with the advent of the COVID-19 pandemic, the age-old ritual has become a no-no, as its role in spreading the disease has been acknowledged. Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a leader of the White House’s Coronavirus Task Force, said in April, “I don’t think we should ever shake hands ever again,” adding, “We’ve got to break that custom. Because as a matter of fact, that is really one of the major ways that you can transmit a respiratory illness.”

And he is right. The practice which, according to, dates back to the 5th century BC in Greece, where it began as a symbol of peace, showing that neither person was carrying a weapon, has been found to be an excellent way in which to transmit not just respiratory, but also diarrhoeal and other infectious diseases.


While the benefits of a good, firm, and sincere handshake are well researched and known, so are the germs that hands can transmit. According to a group of scientists who 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,” adding that they are the “critical vector” for transmitting microorganisms, including viruses.

According to research from the University of Colorado, on average, we carry 3,200 bacteria from 150 different species on our hands. Another study, conducted by Michigan State University and published in 2013, found that after using public rest rooms, only 5 per cent of people wash their hands with soap long enough to get rid of germs, while 15 per cent of men and 7 per cent of women don’t wash up at all.

The efficacy with which hands can spread germs was beautifully, and disturbingly, demonstrated by Japan’s public broadcasting network NHK, along with infectious disease experts from St Marianna University School of Medicine in Kawasaki. The researchers set up a buffet-style meal for 10 people. They placed a little fluorescent paint on the hand of one ‘infected’ person to simulate a cough into their hand, and then let the participants engage in a buffet for the next 30 minutes.

When the fluorescent lights were turned on to reveal the spread of the initial dab of paint, the ‘infection’ seemed to have spread everywhere, ending up on the hands of every single participant, and on the faces of three. The team discovered that the tongs, lids of the dishes, and the handle of the drink container were most to blame for the spread.

Think about it, when you shake someone’s hand you have no idea where it has been. The person may have just urinated, defecated, vomited, masturbated, coughed or sneezed into their hand, ‘dug out’ their nose, petted a dirty animal or handled money, and not practised proper hygiene. After shaking their hand, you might feel a slight itch at the corner of your mouth, reflexly scratch it and bingo … you have transferred some nasty stuff to your respiratory or gastrointestinal system. This scenario plays out all the time, as we humans touch our faces very often, an estimated 23 times an hour, according to one study.

This handshaking thing can be risky business, huh?

Michael Abrahams is an obstetrician and gynaecologist, social commentator and human rights advocate. Email feedback to and, or tweet @mikeyabrahams.