Researchers at the University of Sharjah conducted a cross-sectional survey between February and March 2021, targeting UAE residents aged 18 and above. The study, published in BMC Complementary Medicine and Therapies, gathered responses through self-administered questionnaires distributed via social media platforms, a distribution method that reflected the lockdown conditions under which the data was collected. After analysis using SPSS statistical software, version 26, the team found that while natural remedies were deeply embedded in everyday health practices before the pandemic, they played a surprisingly modest role in COVID-19 prevention and treatment specifically.

The numbers tell a nuanced story. Before the pandemic, a striking 74.6 percent of the 382 participants analyzed reported using natural remedies for disease prevention or treatment, confirming that these products were already a routine part of health maintenance for roughly three out of four adults surveyed. Yet when the same population was asked about remedies specifically aimed at COVID-19, the figures collapsed. Only 27.7 percent reported using natural products to prevent the disease, a mere 3.9 percent used them as treatment after infection, and 11.8 percent reported using them for both purposes combined.

This gap between general use and pandemic-specific use is one of the most intriguing aspects of the study. It suggests that the population did not wholesale abandon conventional public health guidance in favor of herbal alternatives, as some feared during the pandemic’s most chaotic months. Instead, the Emirati respondents appear to have largely maintained their pre-existing habits while relying on official prevention measures, vaccination campaigns, and medical care for COVID-19 itself. The authors suggest this separation between general wellness practices and acute disease management reflects a pragmatic approach to health decision-making.

Demographic analysis revealed that two factors significantly influenced whether individuals turned to natural remedies against COVID-19: sex and age. Women were more likely than men to use natural products for pandemic protection, a pattern consistent with broader literature showing that women tend to be the primary consumers of complementary and alternative medicine worldwide. Age also played a statistically significant role, with the association reaching p = 0.045, while the association with sex reached p = 0.011, both conventional thresholds of statistical significance. Other demographic variables did not show meaningful relationships with remedy use in this sample.

Perhaps most revealing were the perceptions surrounding efficacy. A substantial majority of participants expressed skepticism about natural remedies as pandemic tools. Fully 41.6 percent believed natural remedies had low efficacy in preventing COVID-19, and an even larger 52.9 percent considered them ineffective for treating the disease. In other words, half of the surveyed population regarded herbal and natural approaches as therapeutically weak against the virus itself, even while maintaining their general use of these products for everyday health purposes.

This perception gap between general wellness and acute antiviral protection is scientifically coherent. Many commonly used natural products, such as honey, ginger, garlic, lemon, and various herbal teas, have documented antioxidant, anti-inflammatory, or general immunomodulatory properties that may support overall health. However, none have demonstrated the ability to prevent SARS-CoV-2 infection or to neutralize the virus once it has established itself in the respiratory tract. The respondents’ skepticism, therefore, appears to align with the available scientific evidence, even if it was likely shaped more by personal experience and public messaging than by clinical trial data.

One of the more concerning findings emerged when the researchers examined attitudes toward quarantine. Among participants who had a history of COVID-19 infection, 42.9 percent believed that using natural remedies made quarantine unnecessary, compared with 25.6 percent of those without such a history. This belief, that natural products could substitute for isolation protocols, represents a potential public health risk, as it could encourage infected individuals to continue social contact while relying on remedies that cannot stop viral transmission. The elevated rate among those who had experienced infection suggests that personal experience with the disease may have fostered overconfidence in alternative approaches, or that those who relied on remedies during illness rationalized their choices after the fact.

Interestingly, the study found no significant difference in perceived risk of COVID-19 between natural remedy users and non-users. This challenges a common hypothesis in the complementary medicine literature, which holds that people turn to natural remedies because they fear conventional medicine, distrust pharmaceutical interventions, or perceive the disease itself differently. In the UAE sample, the decision to use or avoid natural products during the pandemic appears to have been driven by other factors, possibly including cultural traditions, family practices, or simple habit, rather than differential risk perception.

The methodology of the study warrants careful consideration when interpreting these findings. The cross-sectional design captures a single moment in time and cannot establish causation. The social media distribution, while practical during lockdown conditions, may have introduced sampling bias toward younger, more digitally connected residents, potentially underrepresenting older adults who might hold different attitudes toward traditional medicine. The relatively modest sample size of 382 participants, while adequate for detecting the observed associations, limits the statistical power available for subgroup analyses. Additionally, the data collection window in early 2021 preceded widespread vaccine availability in many regions, meaning attitudes may have shifted substantially as vaccination campaigns accelerated later that year.

Nevertheless, the study fills an important geographic gap in the global literature on pandemic-era alternative medicine use. Much of the published research on natural remedies and COVID-19 has focused on North America, Europe, and East Asia, leaving the Gulf region comparatively understudied despite its rich traditions of herbal medicine rooted in Arabic and Islamic healing practices. The UAE, with its highly multicultural population comprising Emiratis and large expatriate communities from South Asia, the Middle East, and beyond, offers a particularly interesting setting for such research, as diverse cultural traditions of natural medicine coexist within a modern, well-resourced healthcare system.

The authors conclude that the frequency of natural remedy use for COVID-19 prevention or treatment was very low in the UAE, a finding they interpret with some concern. Rather than viewing low usage purely as a triumph of evidence-based public health messaging, the research team argues that community outreach and public health programs are needed to raise awareness about the potential role of natural remedies in supporting general health and well-being. This framing reflects a growing consensus in integrative medicine that natural products may have a legitimate supportive role in overall wellness, provided they are not positioned as substitutes for vaccination, isolation, or medical treatment.

That dual message, embracing natural remedies for wellness while firmly directing people toward conventional measures for acute infectious disease, captures the delicate balance that public health authorities worldwide have had to strike. On one hand, dismissing traditional and natural medicine entirely risks alienating populations for whom these practices carry deep cultural significance, potentially undermining trust in health institutions more broadly. On the other hand, tolerating claims that honey or herbs can replace proven interventions like vaccination and quarantine invites the kind of dangerous substitution behavior hinted at in the quarantine findings of this very study.

As the world moves into the post-pandemic era, studies like this one provide valuable baseline data for understanding how populations actually behaved during a once-in-a-century health crisis. The UAE findings paint a picture of a population that largely resisted pandemic-specific alternative medicine fads while maintaining its traditional wellness practices, and whose skepticism about herbal antivirals proved largely justified by subsequent scientific evidence. For public health planners preparing for future infectious disease emergencies, the lesson is clear: cultural health practices are resilient and should be respected and integrated where appropriate, but crystal-clear communication about the limits of natural remedies against acute viral infections remains essential to keeping communities safe.

The study conducted by an interdisciplinary team led by researchers Jang, Shin, and Lee, delves into the intricacies of how different preparation methods influence the bioactive components of Palmijihwang-tang. The formula, historically used in Asian medicine, comprises several herbal ingredients, each contributing unique properties that collectively promote health and wellness. However, how these constituents interact during the decoction process has remained a subject of debate and inquiry.

Utilizing a theoretical framework, the researchers meticulously dissected the chemical transformations that occur when the individual ingredients are combined and heated in water. This scientific approach underscores the complexity of herbal interactions, revealing that the functionality of a formula is not merely a sum of its parts but rather a dynamic interplay of active compounds. By showcasing how certain decocting conditions can either enhance or diminish specific bioactive elements, the research opens doors to more personalized and refined applications of traditional herbs.

As the study progresses, it is evident that understanding the chemical architecture of Palmijihwang-tang is crucial for optimizing its health benefits. The research highlights critical factors affecting the extraction and potency of herbal compounds, such as water temperature, steeping time, and ingredient ratios. The implications of these findings extend beyond traditional practices; they suggest pathways for maximizing efficacy in modern herbal preparations, paving the way for further academic inquiry and clinical applications.

One fascinating aspect of the study involves the exploration of synergistic effects—how certain combinations of herbs within Palmijihwang-tang work together to amplify health benefits. This concept of synergy is particularly pivotal in herbal medicine, where the whole is often considered to be greater than the sum of its isolated parts. The researchers emphasized that this synergy can lead to enhanced bioavailability and therapeutic efficacy, underscoring the importance of considering these interactions in future herbal formulations.

Moreover, the investigators found that by selectively adjusting decoction parameters, practitioners may effectively tailor the medicinal qualities of Palmijihwang-tang to meet individual patient needs. This personalized approach is a significant advancement in the field of traditional medicine, bridging the gap between empirical knowledge and scientific evidence. The findings suggest a move towards more individualized medicine, allowing for customized herbal interventions that cater to specific health conditions and patient profiles.

The implications of this research are profound, as they encourage a reevaluation of traditional decoction methods through the lens of modern scientific inquiry. As traditional practices are often steeped in historical context, marrying them with contemporary research provides a richer narrative and broader acceptance among healthcare communities. This interplay between tradition and innovation serves to validate the efficacy of herbal medicine in a world increasingly driven by evidence-based practices.

Moreover, the systematic analysis presents a compelling case for further investigation into other traditional herbal formulations. If the findings regarding Palmijihwang-tang hold true across various formulations, this could revolutionize how practitioners employ these remedies in clinical settings. The research thus opens the door for a new era in the field of herbal medicine, wherein scientists and practitioners alike can collaborate to enhance understanding and therapeutic applications.

The potential for optimized decoction processes extends beyond the immediate study of Palmijihwang-tang; it suggests broader applications in herbal medicine as a whole. Deciding how best to extract and formulate herbal remedies can result in not only increased potencies but also reduced side effects—a common concern in any form of medicine. The researchers advocate for a comprehensive approach in which traditional knowledge and modern science coalesce, providing a holistic avenue for healthcare advancements.

This research also highlights the need for standardization in traditional herbal practices. As more studies emerge, establishing guidelines based on empirical evidence can help authenticate the dosage and preparation methods for practitioners, aiding them in providing the most effective treatments for their patients. Such a framework would not only enhance the credibility of traditional medicines but also reinforce their place in contemporary healthcare.

Furthermore, the researchers called attention to the importance of continued education among herbal practitioners regarding the science behind their practices. By fostering a better understanding of how various factors influence herbal pharmacology, practitioners can make more informed decisions, ultimately leading to improved patient outcomes. Education, therefore, becomes a pivotal component in bridging the gap between traditional knowledge and modern scientific insight.

In conclusion, the study marks a significant milestone for the scientific community, highlighting the vital relationship between traditional Asian medicine and contemporary research methodologies. As we delve deeper into the world of herbal remedies, it is only through studies such as this that we will unlock the full potential of nature’s treasures. The journey of understanding and refining traditional practices is just beginning, but the climate is ripe for innovation and collaboration in the realm of herbal medicine.

Emphasizing a future where traditional knowledge is seamlessly integrated into modern wellness paradigms, this research inspires a renewed appreciation for the art and science of herbal decoctions. As more discoveries surface, we anticipate transformative changes in how these time-honored practices are perceived, treated, and utilized in today’s health-conscious society.

Subject of Research: Modifications in chemical composition of Palmijihwang-tang through combined decoction methods.

Article Title: Combined decoction selectively modifies chemical composition of traditional Asian medicine: a systematic analysis on Palmijihwang-tang using theoretical additive model.

Article References:

Jang, D., Shin, S., Lee, S.M. et al. Combined decoction selectively modifies chemical composition of traditional Asian medicine: a systematic analysis on Palmijihwang-tang using theoretical additive model.
BMC Complement Med Ther 25, 417 (2025). https://doi.org/10.1186/s12906-025-05153-w

Image Credits: AI Generated

DOI: https://doi.org/10.1186/s12906-025-05153-w

Keywords: Herbal medicine, decoction, traditional medicine, Palmijihwang-tang, chemical composition, synergistic effects, personalized medicine.