Monday, March 4, 2024

Should you greet with WHO-recommended elbow bump or fist bump?

If you sneeze into a flexed elbow, is it safe to also use that same elbow to greet people as a substitute of the now-forbidden handshake?

Yes, says Dr. Derrick Tlhoiwe, the Chancellor of DDT School of Medicine at the BBS Mall in Gaborone.

“Coronavirus is not transmitted through the skin but fluids,” says Tlhoiwe, a medical doctor who runs Botswana’s first and only private medical school.

His explanation is that such transmission is likely to occur where an infected hand comes into contact with fluids in the eyes, nose and mouth. There is any number of scenarios in which that hand can come into contact with those body parts. One might for instance, either absentmindedly or reflexively rub their eyes with a hand that not too long ago shook another and contract the virus. Conversely, one can’t rub their eyes or touch their face with an elbow.

A related point that Tlhoiwe is keen to stress is that while one coughs or sneezes into the inside of a flexed elbow, they greet with its outer part – which eliminates the possibility of infection.

The coronavirus pandemic is also seeing greater use of the fist-bump in place of the normal handshake. On the surface, a fist-bump might appear safer because, unlike the elbow bump, doesn’t require people to lean in and so creates greater distance between them. The informed view (Tlhoiwe’s) is that the fist bump is not safe at all because it is also done with the hand. Indeed one can either absentmindedly or reflexively rub their eyes with a virus-bearing knuckle that was used in a fist bump not too long ago.

Next to the elbow–bump as a form of greeting, Tlhoiwe says that the other safe option is to tap feet together (feet-bump) to avoid contracting the virus.

The main part of the global coronavirus public service alert encourages people to periodically disinfect their hands by either washing them with soap or by using a sanitiser with adequate alcohol content. Tlhoiwe expresses grave concern that some of the people administering this process at retail establishments are unqualified and now pose a threat to public health. One example he cites is that some are using ordinary household detergents – like Jik – which has resulted in chemical burn of the skin in some instances. This appears to be widespread problem because many more people are reporting use of similar and unsuitable detergents. Tlhoiwe says that he has had to render expert advice at the nearby flea market where Jik-like substances have been used as coronavirus sanitisers. DDT is itself an ISO-certified manufacturer of sanitisers and its laboratory has been rendering such service as the spectre of coronavirus infections looms over Botswana.


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