Pope Francis hits 3-week mark of hospitalization after giving world a sign of his frailty

ROME (AP) — Pope Francis hit the three-week mark Friday in his hospitalization for double pneumonia, in stable condition, receiving therapy but not necessarily improving, after giving the world a tangible indication of just how frail and sick he is.

The 88-year-old Francis spent 20 minutes in the Gemelli hospital chapel, praying and doing some work in between rest and respiratory and physical therapy, the Vatican said. He was using high flows of supplemental oxygen to help him breathe during the day and a noninvasive mechanical ventilation mask at night.

Doctors not involved in his care said after three weeks of acute care in the hospital for double pneumonia, they would have hoped to have seen improvement and warned that he was increasingly at risk of secondary infections the longer he remains hospitalized. Additionally, Francis has had episodes of acute respiratory failure earlier this week and underwent bronchoscopies to suction mucus from his lungs.

"He’s had respiratory failure and they were not able to liberate him from the hospital in the first three weeks. And therefore I think you’d say this does look concerning, perhaps more concerning than it did right at the beginning,” said Dr. Andrew Chadwick, a respiratory and intensive care specialist at Oxford University Hospitals in England.

Dr. Jeffrey Millstein, a clinical assistant professor of internal medicine at the University of Pennsylvania, said it wasn't shocking that Francis hadn't improved in three weeks, and that it was encouraging he was able to breathe part of the day with just a nasal tube of high-flow oxygen. But he said that his condition certainly was “a precarious, touch and go kind of situation” and that recovery, while still possible, would be a long process.

Going forward, “I just would be looking for no new setbacks," he said. "I think as long as he is dealing with the current issues and he’s just making incremental progress, that would be great.”

Francis offered a first public sign of just how weak he is on Thursday by recording an audio message that was broadcast to the faithful in St. Peter’s Square who had gathered for the nightly recitation of the rosary prayer.

In it, Francis thanked the people for their prayers. But his voice was barely discernible through his labored breaths and he spoke in his native Spanish, not Italian.

“I thank you from the bottom of my heart for your prayers for my health from the square, I accompany you from here,” he said to the hushed square. “May God bless you and the Virgin protect you. Thank you.”

The messaged served many purposes. It was the first public sign of life from the pope since he entered Rome's Gemelli hospital on Feb. 14, and put to rest right-wing conspiracy theories and rumors calling into question his true medical status.

The Vatican said that Francis himself wanted to record it, to thank all those people who had been praying for him. In his Sunday message last weekend, Francis said he had felt the affection of so many people, and felt “as if I am ‘carried’ and supported by all God’s people.”

But the audio also underscored just how weak Francis is. For anyone used to hearing his voice, the message was an emotional punch to the gut that hammered home just how hard it is for him to even breathe.

The pope has chronic lung disease and had part of one lung removed as a young man.

The Vatican has given twice-daily updates on Francis’ condition, but has distributed no photos or video of him since the morning of Feb. 14, when he held a handful of audiences at the Vatican before being admitted to Gemelli hospital for what was then just a bad case of bronchitis.

The infection progressed into a complex respiratory tract infection and double pneumonia that has sidelined Francis for the longest period of his 12-year papacy and raised questions about the future of his papacy.

Maria Cheng reported from London.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

People pray for Pope Francis in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalised since Friday, Feb. 14. (AP Photo/Andrew Medichini)

A nun prays for Pope Francis in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Candles for Pope Francis are seen in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Candles for Pope Francis are seen in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Candles for Pope Francis are seen in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

People pray for Pope Francis in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Tourists sit near Sant'Angelo castle, background, as the sun sets in Rome, Italy, Friday, March 7, 2025. (AP Photo/Francisco Seco)

People pray for Pope Francis in front of the Agostino Gemelli Polyclinic, in Rome, Friday, March 7, 2025, where the Pontiff is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Volunteers carry wooden crosses near St. Peter's Square in Rome, Italy, Friday, March 7, 2025. (AP Photo/Francisco Seco)

Locals and tourists walk along a main street near St. Peter's Basilica, background, as the sun sets in Rome, Italy, Friday, March 7, 2025. (AP Photo/Francisco Seco)

Catholic worshippers pray the Rosary for Pope Francis in St. Peter's Square at The Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

A woman touches the statue of Pope John Paul II placed outside the Agostino Gemelli hospital in Rome, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

Catholic worshippers attend a nightly rosary prayer service for Pope Francis in St. Peter's Square at the Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

Catholic nuns attend a nightly rosary prayer service for Pope Francis in St. Peter's Square at the Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

Catholic nuns listen to a recorded message from Pope Francis during a prayer of the Rosary for Pope Francis in St. Peter's Square at The Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

A Catholic nun shows the back cover of her mobile phone with a photograph of Pope Francis as she attends a nightly rosary prayer service for Pope Francis in St. Peter's Square at the Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

Catholic worshippers pray during a prayer of the Rosary for Pope Francis in St. Peter's Square at The Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

NEW YORK (AP) — Thousands of nurses in three hospital systems in New York City went on strike Monday after negotiations through the weekend failed to yield breakthroughs in their contract disputes.

The strike was taking place at The Mount Sinai Hospital and two of its satellite campuses, with picket lines forming. The other affected hospitals are NewYork-Presbyterian and Montefiore Medical Center in the Bronx.

About 15,000 nurses are involved in the strike, according to New York State Nurses Association.

“After months of bargaining, management refused to make meaningful progress on core issues that nurses have been fighting for: safe staffing for patients, healthcare benefits for nurses, and workplace violence protections,” the union said in a statement issued Monday. “Management at the richest hospitals in New York City are threatening to discontinue or radically cut nurses’ health benefits.”

The strike, which comes during a severe flu season, could potentially force the hospitals to transfer patients, cancel procedures or divert ambulances. It could also put a strain on city hospitals not involved in the contract dispute, as patients avoid the medical centers hit by the strike.

The hospitals involved have been hiring temporary nurses to try and fill the labor gap during the walkout, and said in a statement during negotiations that they would “do whatever is necessary to minimize disruptions.” Montefiore posted a message assuring patients that appointments would be kept.

“NYSNA’s leaders continue to double down on their $3.6 billion in reckless demands, including nearly 40% wage increases, and their troubling proposals like demanding that a nurse not be terminated if found to be compromised by drugs or alcohol while on the job," Montefiore spokesperson Joe Solmonese said Monday after the strike had started. "We remain resolute in our commitment to providing safe and seamless care, regardless of how long the strike may last.”

New York-Presbyterian accused the union of staging a strike to “create disruption,” but said in a statement that it has taken steps to ensure patients receive the care they need.

"We’re ready to keep negotiating a fair and reasonable contract that reflects our respect for our nurses and the critical role they play, and also recognizes the challenging realities of today’s healthcare environment,” the statement said.

The work stoppage is occurring at multiple hospitals simultaneously, but each medical center is negotiating with the union independently. Several other hospitals across the city and in its suburbs reached deals in recent days to avert a possible strike.

The nurses’ demands vary by hospital, but the major issues include staffing levels and workplace safety. The union says hospitals have given nurses unmanageable workloads.

Nurses also want better security measures in the workplace, citing incidents like a an incident last week, when a man with a sharp object barricaded himself in a Brooklyn hospital room and was then killed by police.

The union also wants limitations on hospitals’ use of artificial intelligence.

The nonprofit hospitals involved in the negotiations say they’ve been working to improve staffing levels, but say the union’s demands overall are too costly.

Nurses voted to authorize the strike last month.

Both New York Gov. Kathy Hochul and Mayor Zohran Mamdani had expressed concern about the possibility of the strike. As the strike deadline neared, Mamdani urged both sides to keep negotiating and reach a deal that “both honors our nurses and keeps our hospitals open.”

“Our nurses kept this city alive through its hardest moments. Their value is not negotiable,” Mamdani said.

State Attorney General Letitia James voiced similar support, saying "nurses put their lives on the line every day to keep New Yorkers healthy. They should never be forced to choose between their own safety, their patients’ well-being, and a fair contract.”

The last major nursing strike in the city was only three years ago, in 2023. That work stoppage, at Mount Sinai and Montefiore, was short, lasting three days. It resulted in a deal raising pay 19% over three years at those hospitals.

It also led to promised staffing improvements, though the union and hospitals now disagree about how much progress has been made, or whether the hospitals are retreating from staffing guarantees.

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside New York-Presbyterian Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside Mount Sinai West Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside Mount Sinai West Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside Mount Sinai West Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

Nurses strike outside Mount Sinai West Hospital, Monday, Jan. 12, 2026, in New York. (AP Photo/Yuki Iwamura)

FILE - A medical worker transports a patient at Mount Sinai Hospital, April 1, 2020, in New York. (AP Photo/Mary Altaffer, File)