On December 31, 2019, China announced the discovery of a cluster of pneumonia cases in Wuhan. The first American case of COVID-19 was reported on January 20, and Health and Human Services Secretary Alex Azar declared a public health emergency on January 31. Restrictions were placed on flights arriving from China, but the initial U.S. response to the COVID-19 pandemic was otherwise slow in terms of preparing the healthcare system, stopping other travel, and testing. The first known American deaths occurred in February and in late February President Donald Trump proposed allocating $2.5 billion to fight the outbreak. Instead, Congress approved $8.3 billion and Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 on March 6. Trump declared a national emergency on March 13. The government also purchased large quantities of medical equipment, invoking the Defense Production Act of 1950 to assist. By mid-April, disaster declarations were made by all states and territories as they all had increasing cases. A second wave of infections began in June, following relaxed restrictions in several states, leading to daily cases surpassing 60,000. By mid-October, a third surge of cases began; there were over 200,000 new daily cases during parts of December 2020 and January 2021.