Public Health Security in Collapse: Silent Crisis in Cypriot Hospitals

The quality of healthcare services is not determined solely by the availability of medical technology or the scientific training of staff, but also by the system’s ability to prevent, control, and manage biological risks. Patient safety is the cornerstone of any modern healthcare model. Unfortunately, in Cyprus, available data reveal serious and systemic weaknesses in this area.

According to the World Health Organization’s 2023 Patient Safety Fact File, 1 in 10 patients (10%) in high-income countries suffers harm during hospitalization. Globally, incidents related to patient safety account for 13% of total healthcare expenditure, according to the OECD. Additionally, the European Centre for Disease Prevention and Control (ECDC) reported in 2024 that one in seven hospitalized patients in Cyprus contracts a healthcare-associated infection—more than twice the European average. Cyprus has the highest rate of such infections in the EU, at 13.8%, compared to the EU average of 7%. Moreover, 56% of hospitalized patients in Cyprus receive antibiotics, far exceeding the EU average of 32.4%.

The situation becomes even more concerning when examining daily practices. Approximately 75% of patients receiving antibiotics for surgical prophylaxis are administered them for more than one day—an unjustified practice that contributes to antimicrobial resistance. These findings highlight how focusing the discussion solely on administration and infrastructure distracts from the daily, life-threatening shortcomings within the system.

A critical but often overlooked issue is the hygienic management of hospital linens. The cleanliness and disinfection of bed sheets, uniforms, and surgical garments are a pillar of biological safety—especially in high-risk areas like Intensive Care Units (ICUs), oncology, and internal medicine departments. The use of barrier washers—a recognized international technology—prevents cross-contamination by physically separating the “dirty” and “clean” sides through a dual-door system. This closed-loop laundry process is essential for preventing the spread of pathogens from contaminated to sanitized environments.

Regulations such as the European Standard EN 14065 define the institutional framework for preventing and controlling biological contamination in laundries and are frequently referenced in hospital laundry hygiene requirements. While there is no unified European law mandating the use of barrier washers in all healthcare facilities, strict guidelines and recommendations across Europe strongly promote their use as a preventive measure.

In Sweden, for example, legislation mandates barrier washers in hospitals, nursing homes, and other health institutions to ensure high hygiene standards. Similarly, Germany enforces strict infection control protocols—established by the Robert Koch Institute—which require barrier washers, particularly in surgical and infectious disease units. In the United Kingdom, while not legally mandatory, NHS and other health bodies strongly recommend the use of barrier washers in hospitals, nursing homes, and clinics where infection control is vital.

Cyprus has made some progress in this area, with public hospitals installing barrier washers in key facilities. However, the situation in the private sector is deeply concerning. Private hospitals, clinics, nursing homes, long-term care units, and other health institutions generally lack such specialized systems and often outsource their laundry to external facilities. These commercial laundries typically do not use barrier washers or rely on conventional equipment, failing to meet hygiene and safety standards. This significantly raises the risk of cross-contamination and infection transmission.

Beyond linen management, other areas raise serious alarm. In ICUs, patients with severe infections and vulnerable conditions are often treated in shared spaces without effective isolation, dramatically increasing the risk of hospital-acquired infections. Moreover, disinfection of rooms that housed infectious cases is frequently carried out through simple ventilation over 72 hours, rather than using modern methods such as ozone equipment—a practice outdated and scientifically inadequate. These conditions point to a widespread absence of protocols and a culture of “administrative tolerance” rather than evidence-based risk management.

Cypriot legislation shows a serious gap in this field. There is no legal requirement for the use of barrier washers in private healthcare licensing or in contracts with the Health Insurance Organization (HIO). Nor are there strict quality standards for linen management or other sensitive materials—resulting in a complete lack of accountability mechanisms.

Recommended actions include the immediate enactment of legislation mandating the universal installation of barrier washers in all public and private healthcare facilities, the establishment of a government inspection mechanism to certify disinfection procedures, and the mandatory training of staff in biological safety protocols. Training must not be limited to medical or nursing personnel but should also include technicians, cleaners, laundry handlers, and anyone involved in infection prevention processes.

Healthcare security is not a luxury—it is a fundamental requirement for a trustworthy, humane, and modern health system. Cyprus cannot remain a bystander while hospital-acquired infections, medical errors, and hygiene failures claim lives and strain public finances. The challenge is political, the solution is technically feasible, and the delay is nothing short of negligent.

Evie Theocharous, Policy Officer, Zenox Public Affairs

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