The pope is receiving occasional supplements of oxygen when he needs it and is responding to the strengthened drug therapy he is receiving, they said.

Gemelli hospital Dr. Sergio Alfieri and Francis’ personal physician, Dr. Luigi Carbone, gave the detailed update on Francis’ condition, saying he remains in good spirits and humour. To wit: Alfieri said that when he entered Francis’ suite to greet him on Friday morning as “Holy Father,” the pope replied by referring to Alfieri as “Holy Son.”

The pope suffered from a seasonal infection that has filled hospitals, but with a difference, Alfieri said.

“Other 88-year-old people generally stay at home and watch TV in a rocking chair. Do you know any other 88-year-olds who govern, let’s say, a state and is also the spiritual father of all Catholics in the world? He does not spare himself, because he is enormously generous, so he got tired,″ Alfieri said.

Carbone said that Francis was responding to the drug therapy that was “strengthened” after the pneumonia was diagnosed earlier this week.

He is also fighting a multipronged infection of bacteria, virus and fungus in the respiratory tract.

Doctors said there was no evidence the germs had entered his bloodstream, a condition known as sepsis that they said remains the biggest concern. Sepsis is a complication of an infection that can lead to organ failure and death.

Francis is receiving supplemental oxygen when he needs it through a nasal cannula, a thin flexible tube that delivers oxygen through the nose.

Francis was admitted to Gemelli hospital on February 14 after a case of bronchitis worsened.

Doctors first diagnosed the complex respiratory infection and then the onset of pneumonia in both lungs on top of chronic asthmatic bronchitis. They prescribed “absolute rest”.

As his hospital stay drags on, some of Francis’ cardinals have begun responding to the obvious question that is circulating: whether Francis might resign if he becomes irreversibly sick and unable to carry on.

Francis has said he would consider it, after Pope Benedict XVI “opened the door” to popes retiring, but has shown no signs of stepping down and in fact has asserted recently that the job of pope is for life.

But the question is now in the air, ever since Benedict became the first pope in 600 years to retire when he concluded in 2013 that he didn’t have the physical strength to carry on the rigors of the globe-trotting papacy.

“Everything is possible,” said Cardinal Jean-Marc Aveline, the archbishop of Marseille, France, when asked on Thursday.

Another cardinal, Gianfranco Ravasi, suggested that it was more than just a possibility.

“There is no question that if he (Francis) was in a situation where his ability to have direct contact (with people) as he likes to do … was compromised, then I think he might decide to resign,” Ravasi was quoted as telling RTL 102.5 radio.

Francis confirmed in 2022 that, shortly after being elected pontiff, he wrote a resignation letter in case medical problems impeded him from carrying out his duties. There is no provision in canon law for what to do if a pope becomes incapacitated.

But there is no indication Francis is in any way incapacitated or is even considering stepping aside.

During his hospital stay, he has continued to work, including making bishop appointments. After a hospital stay in 2021, he bristled when he learned that some clergy were allegedly already preparing for a conclave to elect his successor.

Francis had an acute case of pneumonia in 2023 and is prone to respiratory infections in winter.

Doctors say pneumonia in such a fragile, older patient makes him particularly prone to complications given the difficulty in being able to effectively expel fluid from his lungs.

While his heart is strong, Francis isn’t a particularly healthy 88-year-old. He is overweight, isn’t physically active, uses a wheelchair because of bad knees, had part of one lung removed as a young man, and has admitted to being a not-terribly-cooperative patient in the past.

Francis has had two longer hospital stays during his nearly 12-year pontificate. He spent 10 days at Gemelli in 2021 when he had 33 centimetres of his colon removed. In 2023, he was admitted for nine days for surgery to remove intestinal scar tissue and repair an abdominal hernia.

As he recovers this time around, the Catholic faithful have been participating in special moments of prayer.

In the Philippines, Asia’s largest Catholic nation, Filipino worshippers held an hourlong prayer at the Manila Cathedral on Friday for the pope’s rapid recovery. Other Catholics were urged to pray in their homes and communities for the pontiff, who drew a record crowd of 6 million people when he celebrated Mass in a Manila park in 2015, according to official estimates at the time.

“The Philippines has a place very close to his heart,” said the Vatican’s ambassador to Manila, Archbishop Charles John Brown.