Children's Developing Knowledge of and Misconceptions About the Transmission of COVID-19 and the Common Cold

• In Event: Infectious Learning and Teaching: Opportunities and Challenges of Integrating COVID-19 Into K–16 Education

Abstract

OBJECTIVE: In order to design effective interventions and curricula for educating children about viral transmission, we must understand the knowledge and misconceptions children bring to the table. The present study investigated what children understand about the underlying causal mechanisms of the transmission of COVID-19 and the common cold, as a point of comparison.

FRAMEWORK: Previous work on children’s understanding of viral transmission has found that children can better obey public health guidelines when they understand the relevant causal mechanisms (Au et al., 2008). The present study aims to discover how children reason about COVID-19 viral transmission, focusing on three key components: (1) Viruses as quasi-living agents (Villarreal, 2004) that can replicate within the cell of a living host, and can be destroyed by soap and antimicrobial pesticides. (2) Viruses as different from other living organisms, because when outside the host's body they cannot function and ultimately will not survive. (3) Understanding processes that are "below the surface", often defying the observable cause-effect relations that children are more familiar with. Thus, although illness itself may have observable signs (a cough), and illness transmission may have observable signs (spray from a sick person's sneeze landing on another), neither illness nor transmission need be observable, and the underlying biological processes are themselves unavailable to direct visual inspection.

METHOD/EVIDENCE: Participants were 194 5-12-year-old children and 362 adults. Each child participated in two interviews, one regarding COVID-19 and one regarding the common cold. Participants were asked 40 closed-ended and 13 open-ended questions that provided a rich assessment of their causal understanding of viral transmission. Concepts included: asymptomatic disease and transmission, lag between infection and disease onset, that viruses are capable of replicating inside the body but are not capable of self-movement, eating, or growing in size, etc.

RESULTS: Analyses are ongoing. Preliminary analyses suggest that a belief in disease transmission seems to be stronger in children than adults, with children more often than adults reporting that a virus could enter the body through the feet, or that one could get sick from touching a sneezed-on package even after it was sitting untouched for a week. Simultaneously, our preliminary data also suggest that children are less aware of the mechanisms underlying disease transmission. Many children reported that someone without symptoms cannot have the disease, and cannot transfer the disease to others. And although children are quite knowledgeable about basic dos and don'ts, such as washing hands or wearing masks, they generally fail to mention biological processes to explain these recommendations.

SIGNIFICANCE: Developing effective means of educating children about disease transmission is a matter of vital concern, not only for scientific literacy, but also for public health. Although viral transmission is not currently in the science curricula for K-5 children in the US, they are developing theories from information in non-school contexts. The present study provides insight into what children do and don’t know about the viral transmission process which, in turn, helps establish where interventions may be necessary and how this may inform behavioral outcomes.

Authors

• Danielle Labotka, University of Michigan - Ann Arbor

• Susan Gelman