In March 2020 there was no vaccine, no established treatment, and hospitals in several cities were close to capacity. One retrospective cost-benefit analysis of the first six months estimated that US mitigation measures averted between roughly 866,000 and 1.7 million deaths, against 58,000 to 245,000 deaths attributable to the economic downturn. Supporters argue that buying time until vaccines arrived was the entire point. Critics respond that such estimates rest on modelled counterfactuals that cannot be observed, and that the same paper found the net effect on quality-adjusted life years ambiguous.