In early February 2020, Diana Toomer was in Phoenix, Arizona, during a site visit where CDC staff were training people who respond to inquiries received by CDC-INFO – CDC’s national contact center. She remembers a sharp uptick in calls and meetings while a mysterious coronavirus-related condition was gaining attention and concern. “I remember things just mushrooming up so fast. All the meetings were cranking up, and I was listening to press briefings trying my best to keep up with all the action.” In a matter of weeks, CDC-INFO became one of the most influential tools to share timely and accurate information with the public on COVID-19.
Diana is one of 30 staff who make up the CDC-INFO branch. With more than 30 years at CDC, she brings her love of biology and human health combined with her expertise in English and communication to her role as Content Team Lead. Her team works across all CDC programs to develop and tailor accurate and understandable information that is packaged in an accessible and efficient manner for the CDC-INFO agents. Katie Tolleson, a member of this team, describes her role as “a job where I feel like I’m learning something new every single day.” Entering CDC as an ORISE Fellow in 2016, Katie now serves as a Health Communications Specialist for CDC-INFO. She coordinates with various experts across the agency to identify trending topics and help build the portfolio of content in a plain language and straightforward way. “I really enjoy being connected to this service that provides people with important information to help them make decisions about their health.”
Designed to handle all public inquiries via phone, email, or postal mail, CDC-INFO is organized with a CDC staff component and contracted contact centers where agents handle all inquiries. About 80% of these inquiries are phone calls. Most of the remaining inquiries arrive via email, and a very small amount come in the mail. Normal hours of operation are from 8 a.m. to 8 p.m., Monday through Friday Eastern Time, and inquiries are handled by 50 agents. COVID-19 changed all that.
As COVID-19 news was accelerating, CDC-INFO became the hub for questions from every sector. As CDC-INFO’s main point of contact during an emergency response, Sarah Hines recalls this period as one where “data from CDC-INFO became an essential resource to develop content for a growing and anxious audience.” Rapidly designed reports and summaries from CDC-INFO made their way to communication teams across the response.
“From there, most of the early content for CDC-INFO was tailored to be timely, accurate, and responsive to the needs of the public,” Sarah says. CDC-INFO was capturing the priorities of the nation’s concerns and quickly delivering those concerns across the developing agency response.
“CDC-INFO supports an emergency response from start to finish and adapts along the way,” Sarah explains. “On March 2, 2020, CDC-INFO became a 24/7 service and in the first month, agents handled over 34,000 calls and close to 57,000 emails about COVID-19.” Over time, the number of agents surged from 50 to 500, and the average number of calls per day jumped from 900 to more than 1,600. Daily emails doubled. Agents who typically work in two contact centers based in Mississippi and Arizona became a remote workforce. Following emergency use authorization of the COVID-19 vaccine, a National Vaccine Hotline was added to the CDC-INFO services. In a typical year, CDC-INFO would handle 300,000 inquiries on over 750 topics. Since January 2020, inquiries for COVID-19 only have exceeded 1.5 million.
Sarah describes CDC-INFO as “the main place where two-way communication takes place with the public. It offers people connection to a human voice where they are heard and respected. The agents take on that tremendous task with patience and dedication. They’re not answering phones with people ordering from a catalog. They’re providing real-time responses to people’s concerns about themselves or a loved one. Sometimes, there’s no question at all and people are seeking a patient and listening ear.”
CDC agents operate with a sophisticated set of tools that is continually updated and improved by CDC staff. “Agents have access to an A-to-Z list to quickly determine if the topic is in or out of scope for CDC, over 4,000 prepared responses, CDC’s website, and streamlined triage and contact information to forward more complex inquiries to various CDC programs,” Sarah explains. Most agents are generalists and respond to inquiries from the public. There are also a smaller number of specialists with medical or health backgrounds who handle inquiries from health professionals.
“It is because of the team’s stability and expertise that CDC-INFO has been able to answer the ongoing deluge of complex questions; tailor responses to be clear, helpful, and caring; and continually improve processes,” said CDC-INFO Branch Chief Rachel Ciccarone. Rachel has led the CDC-INFO branch since 2013. “We are a unique entity with a heavy operational and procedural focus. The learning curve is steep, but our core team has been here for years, and that consistency gives us great opportunity to focus on improvement. With the addition of IT Specialist Hoang-Khiem Ha, on our team, CDC-INFO has expanded its data and analytics capacity, moving from spreadsheets to a highly visual format with multiple custom reports.” Routinely collected data play an instrumental role in quality and process improvement. CDC’s public-facing information and content are frequently clarified and enhanced by these summaries.
Agents are often the first to identify information gaps as they hear directly from the public where misinformation and confusion exist. COVID-19 took this to a new level. Distrust and disinformation became a major challenge as the public was deluged with an overload of information on COVID-19 from many sources, not all of them credible. In response, Rachel and her team regularly review the CDC-INFO custom reports to identify information gaps and misinformation and then work with CDC experts to update the prepared responses and tools that agents need to do their jobs well.
These tools are vital to the agent’s role, but the team also recognizes that beyond the information provided, it is the compassion and perseverance that callers appreciate most. As Diana says, “We are representing CDC with every call we take and every email we respond to, showing CDC as a reputable and informed agency that cares and responds to people’s needs.”