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This paper explores some competing mental models of how infectious diseases spread and shows how these models influenced the scientific process and the kinds of facts that were generated, legitimized and used to support policy. A central theme in the paper is the relative weight given by dominant scientific voices to probabilistic arguments based on experimental measurements versus mechanistic arguments based on theory. Two examples are explored: the cholera epidemic in nineteenth century London\u2014in which the story of John Snow and the Broad Street pump is retold\u2014and the unfolding of the COVID-19 pandemic in 2020 and early 2021\u2014in which the evidence-based medicine movement and its hierarchy of evidence features prominently. In each case, it is shown that prevailing mental models\u2014which were assumed by some to transcend theory but were actually heavily theory-laden\u2014powerfully shaped both science and policy, with fatal consequences for some.<\/jats:p>","DOI":"10.1098\/rsfs.2021.0017","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T13:23:51Z","timestamp":1633958631000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Miasmas, mental models and preventive public health: some philosophical reflections on science in the COVID-19 pandemic"],"prefix":"10.1098","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2369-8088","authenticated-orcid":true,"given":"Trisha","family":"Greenhalgh","sequence":"first","affiliation":[{"name":"Oxford OX2 6GG, UK","department":["Primary Care Health Sciences, University of Oxford,"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","reference":[{"key":"2026010712434974000_RSFS20210017C1","doi-asserted-by":"crossref","first-page":"20160153","DOI":"10.1098\/rsta.2016.0153","article-title":"Big data need big theory too","volume":"374","author":"Coveney","year":"2016","journal-title":"Phil. 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