Handshake alternatives for a germ-filled world

household cleaner with rubber gloves bucket and sponge..Today when I called my doctor to make an appointment for my annual exam the scheduler asked me several questions – “Have you been out of the country within the past 21 days?” “Have you been around anyone who has been out of the country within the past 21 days?” “Are you sick?” I knew immediately she was screening patients for possible exposure to Ebola.

A couple of weeks ago I gave a training to a group of people who work for an assisted living property management company. I taught handshakes, as I usually do in my First and Lasting Impressions training, and covered the history of them, why and when we shake hands and how to have a confident handshake. One of the participants asked if we should still be shaking hands given germs like Ebola. I responded as I usually do when I’m asked about germs being passed via a handshake. I said a handshake is the appropriate way to greet people and one can wash their hands or use hand sanitizer soon after shaking hands.

I have always been adamant about not giving up handshakes for fear of germs. It is the way we have greeted each other in the United States and many other countries since the middle ages and it is an important gesture that helps us form an impression of someone. But, after my call with my doctor’s office and the news about Ebola I am changing my tune.

The risk of Ebola becoming an epidemic in the United States is very low. We are already screening people for fevers who are flying in from affected countries. Although that is not guaranteed to stop someone who either doesn’t yet have symptoms or who takes something to reduce their fever. But, we also have one of the best medical systems and epidemic containment programs in the world. However, given how deadly the disease is we need to take precautions to keep from spreading it should it become more widespread.

I decided to reach out to my fellow etiquette consultants on a LinkedIn group to see what their thoughts were. Most of the group agreed that we do need to be careful because there is the risk a handshake could pass the virus through a sweaty hand to a hand that has a small break in the skin. It’s a small risk, but it is a risk nevertheless.

We etiquette experts thought it would be important to provide people with some handshake alternatives. We haven’t settled on just one and probably never will, but a few options were cited. There is the Japanese bow with your hands down by your side. Another one is the East Indian Namaste approach where you put your hands together at your chest and bow somewhat. In West Africa people are greeting by clasping one’s hands together and nodding.  There is also the elbow bump.

Because not everyone will know about the handshake alternatives nor stop shaking hands, at least initially, there might be some awkward interactions as you do one thing and the other person reaches out for a handshake. To make it clear you’re not shaking hands, as soon as you’re being introduced to someone use whatever greeting version you plan to use and say, “Nice to meet you. I’m forgoing a handshake to keep from spreading germs.” Or, as my etiquette trainer Maria Everding with The Etiquette Institute said, you could say, “I’m just getting over a cold, and I don’t want to spread my germs, so I’m going to refrain from shaking your hand.”

If someone is sick and offers their hand, simply use one of the handshake alternatives listed above. If you are sick, do not offer to shake hands with others. Just say, “I’ve got a cold and don’t want to give you my germs.”

I can’t see myself not shaking hands at this point but I know I’ll keep hand sanitizer with me and wash my hands regularly. I will also be teaching the handshake alternatives in my trainings so people can decide how they want to handle greetings. If the epidemic spreads into the United States beyond the three it has infected I will start using a different form of greeting such as the hand clasp or the Namaste.

I’d love to know your thoughts. Do you think we should stop shaking hands now? If so, what greeting seems appropriate to you? And, what do you plan to say when not shaking hands?


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Arden Clise is founder and president of Clise Etiquette. Her love for business etiquette began in previous jobs when she was frequently asked for etiquette, public speaking and business attire advice by executives and board members. The passion for etiquette took hold and compelled Arden to start a consulting business to help others. Read more >>


  1. Angie on January 2, 2017 at 11:13 am

    My right hand fingers are always swollen and the worst is now locked. I try not to shake hands but at church it’s hard some people aren’t comfortable with hugging strangers. One gentleman this Sunday really hurt me but he didn’t know and I didn’t know he had such a strong grip. Screeching out in pain he was very apologetic. My best friend afterwards suggested alternatives to hand shakes. I think the one I like best is the namaste greeting. I don’t get hurt and I show respect. But I have a question what do you recommend for job interviews?

  2. Arden Clise on January 4, 2017 at 5:14 pm

    HI Angie,

    I’m sorry your hand is swollen. If it’s painful to shake hands then you should absolutely avoid it. I think the Namaste gesture is just fine. Interviews are a little trickier. You can still do the Namaste gesture but explain why you are doing it. You don’t need to go into great detail, just a sentence two about having a swollen hand that makes it painful to shake hands.

    I hope that helps.

  3. Shef on February 8, 2020 at 4:28 pm

    Namaste ?. I am a Hindu living in the San Francisco Bay Area and yes would love it if Americans adopted Namaste. It means I bow to the Divine in you. No germs yet very respectful. I don’t use it for the fear of it adding another factor of being judged as foreign and exotic. Please try and make it mainstream. Especially now with all the Corona virus going around I am finally beginning to realize why our grandparents practised Namaste, vegetarianism, protected trees and animals in their everyday worship. Took me a huge health crisis after working as a busy Doctor of Pharmacy trained in western medicine for 23 years to start going back to my roots .

  4. Arden on October 14, 2020 at 3:31 pm

    Thank you for sharing more about the Namaste greeting Shef. I do think it will be used more and more because of the pandemic. People are going to be nervous about shaking hands.

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