The release of the photo a month into his treatment came after dozens of young people gathered under the pontiff’s windows to offer wishes for a quick recovery.

With Pope Francis entering his fourth week in hospital, those working in the Apostolic Palace are grappling with the continuing uncertainty over the pope’s health. The same is true for everyone in the Vatican.

The 88-year-old pontiff is now able to spend some time during the day off high flows of oxygen and use just ordinary supplemental oxygen delivered by a nasal tube, the Holy See press office said. Doctors are also trying to cut back on the amount of time he uses a noninvasive mechanical ventilation mask at night, to force his lungs to work more.