In 2006, due to fears of a possible avian flu pandemic, the WHO proposed using the elbow bump as a means of "keeping other people's cooties at arms length.
"[2] Michael Bell has been a principal advocate for using the elbow bump, noting that it can also help constrain the spread of diseases such as Ebola, by modeling social behavior that limits physical contact.
[3] As in 2006, the elbow bump was supported by a number of health officials,[8] such as Sanjay Gupta, CNN's chief medical correspondent.
[11] During the early stages of the COVID-19 pandemic in the United States, health officials advised people to avoid physical contact with others, including handshaking; the elbow bump was suggested as an alternative.
[4] By 2009, the elbow bump was endorsed by many university officials,[15] Nobel laureate Peter Agre,[16] then President of the American Association for the Advancement of Science, and the World Health Organization.