As of 2016, the government ended funding for public health, leaving many employees without salary. The impacts of the outbreak were exacerbated by the collapse of the Yemeni health services, where many health workers remained unpaid for months. A months-long strike of sanitation workers over unpaid wages contributed to the accumulation of garbage that entered the water supply. Qadri, Islam and Clemens write that the dramatic April 2017 resurgence coincided with heavy rains, and "was amplified by war-related destruction of municipal water and sewage systems". An International Committee of the Red Cross (ICRC) worker in Yemen noted that April's cholera resurgence began ten days after Sana'a's sewer system stopped working. Raslan et al write in Frontiers in Public Health: Rainy season Epidemiological modelling of the outbreak from October 2016 to January 2016 together with satellite image-derived meteorological data showed that the rainfall had a strong impact in increasing the chances of transmission, with the rainy season of April 2017 having coincided with the onset of the second wave of the outbreak topping at more than 50,000 cases per week. The geography of Yemen means that the Western mountainous plateau sees more rainfall, and has therefore an increased risk of high cholera incidence due to water precipitations. Lack of vaccination The International Coordinating Group on Vaccine Provision, which maintains vaccine stockpiles for cholera, announced a plan in June 2017 to send one million doses of oral cholera vaccine (OCV) to Yemen, but this plan stalled. Controversy surrounded whether vaccination was the best strategy, whether it was too late to start a vaccination campaign, whether there was enough stockpiled vaccine to meet worldwide needs, whether all of the reported cases of cholera in Yemen were true cases as opposed to simply cases of diarrhea or other similar symptoms, and the effectiveness of the vaccine. The request for vaccine was retracted. In May 2018, the first OCV campaign in Yemen was launched. The WHO and UNICEF delivered oral vaccines to 540,000 individuals in August 2018. Federspiel and Ali write in BMC Public Health: COVID-19 pandemic The COVID-19 pandemic in Yemen is part of the worldwide pandemic of coronavirus disease 2019. As of 12 November 2020, there were 2,070 confirmed cases and 602 deaths. The COVID-19 pandemic has further burdened the already overwhelmed healthcare system in Yemen fighting a number of diseases including cholera, dengue fever, and malaria. Only half of existing health facilities