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Abstract The COVID‐19 pandemic in the United States has had a disproportionate impact on Black, low‐income, and elderly individuals. We recruited 175 predominantly white children ages 5–12 and their parents (N = 112) and asked which of two individuals (differing in age, gender, race, social class, or personality) was more likely to get sick with either COVID‐19 or the common cold and why. Children and parents reported that older adults were more likely to get sick than younger adults, but reported few differences based on gender, race, social class, or personality. Children predominantly used behavioral explanations, but older children used more biological and structural explanations. Thus, children have some understanding of health disparities, and their understanding increases with age. 

How people reason about disease transmission is central to their commonsense theories, scientific literacy, and adherence to public health guidelines. This study provided an in-depth assessment of U.S. children’s (ages 5-12, N=180) and their parents’ (N=125) understanding of viral transmission of COVID-19 and the common cold, during the first year of the COVID-19 pandemic. The primary aim was to discover children’s causal models of viral transmission, by asking them to predict and explain counter-intuitive outcomes (e.g., asymptomatic disease, symptom delay, viral replication) and processes that cannot be directly observed (e.g., viral replication, how vaccines work). A secondary aim was to explore parental factors that might contribute to children’s understanding. Although even the youngest children understood germs as disease-causing and were highly knowledgeable about certain behaviors that transmit or block viral disease (e.g., sneezing, mask-wearing), they generally failed to appreciate the processes that play out over time within the body. Overall, children appeared to rely on two competing mental models of viruses: one in which viruses operate strictly via mechanical processes (movement through space), and one in which viruses are small living creatures, able to grow in size and to move by themselves. These results suggest that distinct causal frameworks co-exist in children's understanding. A challenge for the future is how to teach children about illness as a biological process without also fostering inappropriate animism or anthropomorphism of viruses. 

Disease transmission is a fruitful domain in which to examine how scientific and folk theories interrelate, given laypeople’s access to multiple sources of information to explain events of personal significance. The current paper reports an in-depth survey of U.S. adults’ ( N = 238) causal reasoning about two viral illnesses: a novel, deadly disease that has massively disrupted everyone’s lives (COVID-19), and a familiar, innocuous disease that has essentially no serious consequences (the common cold). Participants received a series of closed-ended and open-ended questions probing their reasoning about disease transmission, with a focus on causal mechanisms underlying disease contraction, transmission, treatment, and prevention; non-visible (internal) biological processes; and ontological frameworks regarding what kinds of entities viruses are. We also assessed participants’ attitudes, such as their trust in scientific experts and willingness to be vaccinated. Results indicated complexity in people’s reasoning, consistent with the co-existence of multiple explanatory frameworks. An understanding of viral transmission and viral replication existed alongside folk theories, placeholder beliefs, and lack of differentiation between viral and non-viral disease. For example, roughly 40% of participants who explained illness in terms of the transmission of viruses also endorsed a non-viral folk theory, such as exposure to cold weather or special foods as curative. Additionally, participants made use of competing modes of construal (biological, mechanical, and psychological) when explaining how viruses operate, such as framing the immune system response (biological) as cells trying to fight off the virus (psychological). Indeed, participants who displayed greater knowledge about viral transmission were significantly more likely to anthropomorphize bodily processes. Although comparisons of COVID-19 and the common cold revealed relatively few differences, the latter, more familiar disease elicited consistently lower levels of accuracy and greater reliance on folk theories. Moreover, for COVID-19 in particular, accuracy positively correlated with attitudes (trusting medical scientists and taking the disease more seriously), self-protective behaviors (such as social distancing and mask-wearing), and willingness to be vaccinated. For both diseases, self-assessed knowledge about the disease negatively predicted accuracy. The results are discussed in relation to challenges for formal models of explanatory reasoning.