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Rationale To understand novel diseases, patients may draw comparisons to other diseases. Objective We examined whether mentally associating specific diseases with COVID-19 was related to self-reported protective behaviors early in the pandemic. Methods In March 2020, a national sample of 6534 U.S. adults listed diseases that came to mind when thinking of COVID-19. They self-reported protective behaviors, demographics, and COVID-19 risk perceptions. Results Participants associated COVID-19 with common infectious diseases like seasonal influenza (59%), common cold (11%), and pneumonia (10%), or emergent infectious diseases like pandemic influenza (28%), SARS/MERS (27%), and Ebola (14%). Seasonal influenza was most commonly mentioned, in all demographic groups. Participants mentioning seasonal influenza or common cold reported fewer protective behaviors. Those mentioning pneumonia or emergent infectious diseases reported more protective behaviors. Mentioning pneumonia, SARS/MERS, and Ebola was associated with the most protective behaviors, after accounting for other generated diseases, demographics, and risk perceptions (e.g., for avoiding crowds, OR = 1.52, 95% CI = 1.26, 1.83; OR = 1.28, 95% CI = 1.13, 1.46; OR = 1.30, 95% CI = 1.11, 1.52, respectively). Conclusions Early in the pandemic, most participants mentally associated COVID-19 with seasonal flu, which may have undermined willingness to protect themselves. To motivate behavior change, COVID-19 risk communications may need to mention diseases that resonate with people while retaining accuracy.