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ABC News March 4, 2020

Wave goodbye to handshakes during coronavirus emergency

WATCH: How to wash your hands the right way

With growing health concerns across the globe amid the COVID-19 emergency, people have found themselves in a bit of a bob-and-weave situation when it comes to simple gestures like hugs and handshakes.

PHOTO: Medical personnel in protective suits wave hands to a patient who is discharged from the Leishenshan Hospital after recovering from the novel coronavirus, in Wuhan, China, March 1, 2020.
China Daily/Reuters
Medical personnel in protective suits wave hands to a patient who is discharged from the Leishenshan Hospital after recovering from the novel coronavirus, in Wuhan, China, March 1, 2020.

From China to Germany, here are some of the awkward interactions and alternate moves that have replaced physical greetings.

MORE: Coronavirus live updates: Los Angeles County becomes 2nd to declare state of emergency
PHOTO: Washington Gov. Jay Inslee bumps elbows with a worker at the seafood counter of the Uwajimaya Asian Food and Gift Market, March 3, 2020, in Seattle's International District.
Ted S. Warren/AP
Washington Gov. Jay Inslee bumps elbows with a worker at the seafood counter of the Uwajimaya Asian Food and Gift Market, March 3, 2020, in Seattle's International District. Inslee said he's doing the elbow bump instead of shaking hands to prevent the spread of germs.

England: Queen adds white gloves to royal wardrobe

The queen wore gloves during an investiture ceremony at Buckingham Palace on Tuesday, during which members of the royal family place medals on people and shake hands with award recipients.

PHOTO: Queen Elizabeth wears gloves as she awards the MBE (Member of the Order of the British Empire) to Harry Billinge from St Austell, during an investiture ceremony at Buckingham Palace in London, March 3, 2020.
Dominic Lipinski/AP
Queen Elizabeth wears gloves as she awards the MBE (Member of the Order of the British Empire) to Harry Billinge from St Austell, during an investiture ceremony at Buckingham Palace in London, March 3, 2020.

ABC News royals contributor Robert Jobson said after 30 years covering the royal family it was "the first time" in memory "that Her Majesty has worn gloves for an investiture."

"It is clear that she is acting on advice and her doctors are taking no chances," he added.

MORE: Queen Elizabeth wears gloves at investiture ceremony amid coronavirus scare

Queen Elizabeth, 93, does often wear gloves at other royal engagements, but wearing them for an investiture ceremony was very unusual.

Panama: 'Footshake' for now -- or take a bow

Walter Cotte W., regional director of the International Federation of the Red Cross and Red Crescent for America and the Caribbean, shared a few alternatives first suggested by the Yong Loo Lin School of Medicine.

pic.twitter.com/iPWbN82jsX

— Walter Cotte W. (@waltercotte) March 1, 2020

Health officials suggest a wave, a pat on the back or even just a look in the eye are safer alternatives than many traditional greetings.

Germany: Strong eye contact instead of an extended appendage

PHOTO: German Interior Minister Horst Seehofer refuses to shake the hand of German Chancellor Angela Merkel for hygienic reasons before a migration summit at the Chancellery in Berlin, Germany, March 2, 2020.
Hannibal Hanschke/Reuters
German Interior Minister Horst Seehofer refuses to shake the hand of German Chancellor Angela Merkel for hygienic reasons before a migration summit at the Chancellery in Berlin, Germany, March 2, 2020.

German chancellor Angela Merkel was waved off by interior minister Horst Seehofer when she went in for a handshake at a meeting on migration Monday.

The pair were seen smiling immediately after, and Seehofer reportedly said he's stopped offering handshakes amid coronavirus.

Expert takeaways to stay away from germs

COVID-19, the disease caused by the new coronavirus, is a respiratory illness spread primarily from person to person by people in close contact with one another -- about 6 feet. Adults over 65, young children, pregnant women and people with compromised immune systems from autoimmune diseases or chronic heart, lung or kidney conditions are at an increased risk of complications.

While it's inevitable for handshakes to transmit microorganisms through human-to-human contact, Nicky Milner, director of medical education at Anglia Ruskin University's School of Medicine, told ABC News that it's actually longer forms of contact that present a problem.

"On most occasions, this will cause no harm at all," she explained. "Greetings which have a longer contact time between people, or involve using a larger surface area, such as hand shaking, result in transmission of higher numbers of microorganisms. If any of these organisms have the ability to cause disease then our greetings can play a role in the transmission from person to person."

"It is important to recognize that we each have a role to play in limiting the spread of infections," she added.

Cultural shift

Although the World Health Organization has endorsed some of these optional greetings in a fairly tongue-in-cheek way, now is a good time to consider serious changes.

Milner said while it can be a challenge to have the public widely implement new greeting methods, especially if it requires a "shift in culture," there's a new range of possibilities "being observed and recommended."

"Being mindful that other people who you are greeting may not choose to shake hands and this is not considered to be rude," she said. "If a permanent ban on handshaking were to be introduced, I think that this would be very difficult to implement. However, raising awareness of our individual responsibility to wash our hands effectively is an important message to communicate to the members of the public."

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Although, when CDC-recommended handwashing is practiced, a handshake could be better than some more tactile greetings in the U.K. and much of Europe.

"The culture of kissing is a common form of greeting in some countries. During widespread respiratory outbreaks, this is perhaps not an ideal form of greeting, and a handshake might be seen to be to be lower risk," Milner explained. "Although it is recognized that this is not always possible."

Best practices worldwide

"Raising awareness of the importance of effective handwashing is considered to be the most effective strategy when trying to minimize the spread of infections at all times," Milner said.

As the outbreak of the novel coronavirus continues, short-term changes like waving off handshake culture could prove effective.

Check out more here on how to properly wash your hands and keep your areas, especially in the workplace, clean.

ABC News' Guy Davies contributed to this report.