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Mandatory stay-at-home orders and business closures may not be more effective at controlling the spread of the coronavirus than less restrictive, voluntary measures, a new study found.

At the beginning of the pandemic, Sweden and South Korea did not implement mandatory lockdowns in the form of stay-at-home orders and business closures, though many people still isolated and followed measures to mitigate the spread of the virus voluntarily. 

Sweden relied on "social distancing guidelines, discouraging of international and domestic travel, and a ban on large gatherings," while South Korea relied on "intensive investments in testing, contact tracing, and isolation of infected cases and close contacts."

The findings appeared in the European Journal of Clinical Investigation. 

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The Stanford University researchers compared the spread of COVID-19 in Sweden and South Korea to the spread in eight countries that did implement more restrictive mandatory lockdowns: Britain, France, Germany, Iran, Italy, Netherlands, Spain and the United States. 

They found that nonpharmaceutical interventions were effective in nine out of 10 countries, but there was "no clear, significant beneficial effect of [more restrictive non-pharmaceutical interventions] on case growth in any country." 

The researchers pointed out that while they found "no evidence of large anti-contagion effects from mandatory stay-at-home and business closure policies," cross-country comparisons were difficult because "countries may have different rules, cultures, and relationships between the government and citizenry."

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This does not mean that measures to mitigate the spread of COVID-19 are ineffective, just that more restrictive nonpharmaceutical interventions may not provide more benefits than less restrictive voluntary measures, according to these researchers. 

"While small benefits cannot be excluded, we do not find significant benefits on case growth of more restrictive [nonpharmaceutical interventions]," the study concluded. "Similar reductions in case growth may be achievable with less restrictive interventions."

Other studies have found that lockdowns do work.

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For instance, researchers from Rice University found in a study last month that "states that are more open are susceptible to higher COVID-19 death rates."

"The increasingly strong relationship between high levels of openness and high [daily deaths per million] suggests that lockdowns have been effective in both reducing [daily deaths per million] in highly infected states and in preventing new spikes in deaths."

Another study by researchers at Columbia University found that "school closures and voluntary or mandated stay-at-home measures" reduced the spread of COVID-19 in New York City last spring by 70%.