ROME (AP) — Pope Francis suffered a bronchial spasm on Friday that resulted in him breathing in vomit, requiring non-invasive mechanical ventilation, the Vatican said in relaying a setback in his two-week long battle against double pneumonia.

The 88-year-old pope responded well, with a good level of gas exchange, and remained conscious and alert at all times, the Vatican said in its late update.

The development marked a setback in what had been two successive days of increasingly upbeat reports from doctors treating Francis at Rome’s Gemelli hospital since Feb. 14.

The episode, which occurred in the early afternoon, resulted in a “sudden worsening of the respiratory picture.” Doctors decided to keep his prognosis as guarded.

The Vatican has already made alternative plans for Ash Wednesday next week, making clear Francis still had a long road ahead. Cardinal Angelo De Donatis, a Vatican official and former vicar of Rome, will preside over the March 5 ceremony and procession that inaugurates the church's solemn Lenten season leading up to Easter in April.

Earlier Friday, Francis had spent the morning alternating high flows of supplemental oxygen with a mask and praying in the chapel. He had had breakfast, read the day's newspapers and was receiving respiratory physiotherapy, the Vatican said.

Doctors did not resume referring to Francis in “critical condition," which has been absent from their statements for three days.

Prayers continued to pour in

In Mexico City, a few dozen people gathered Thursday night at the cathedral to pray for Francis’ recovery.

“He is like part of the family,” said Araceli Gutiérrez, who treasures the time she saw the pope during his trip to the country of nearly 100 million Catholics in 2016. “That’s why we feel so concerned for him.”

María Teresa Sánchez, who was visiting from Colombia with her sister, said that she has always felt close to Francis — the first Latin American pope.

“That’s like having a relative within the higher-ups, with God,” she said. “He has done so much for religion; he’s such a humble person.”

Upcoming calendar in question

Despite his improvements, Francis’ near-term upcoming calendar of events was being changed: The Vatican canceled a Holy Year audience scheduled for Saturday, and it remained to be seen if Francis would skip his Sunday noon blessing for the third week in a row. With Ash Wednesday now delegated to a cardinal, the next major events come during Holy Week and Easter, which this year falls on April 20.

In past years, when Francis has battled bronchitis and influenza in winter, he curbed his participation in Ash Wednesday and Holy Week events, which call for the pope to be outdoors in the cold leading services, participating in processions and presiding over prayers in the solemn period in which the faithful commemorate Christ’s crucifixion and resurrection.

Beyond that, Francis has a few major events coming up that he presumably would hope to keep if well enough. On April 27, he is due to canonize Carlo Acutis, considered to be the first millennial and digital-era saint. The Vatican considers the Italian teenager, who died of leukemia in 2006 at the age of 15, an inspiration for young Catholics.

Another important appointment is the May 24 commemoration of the 1,700th anniversary of the Council of Nicea, Christianity’s first ecumenical council. The spiritual leader of the world’s Orthodox Christians, Patriarch Bartholomew I, has invited Francis to join him in Iznik, Turkey, to commemorate the anniversary, which he has called an important sign of reconciliation between the Catholic and Orthodox churches. Before he got sick, Francis said he hoped to go, though the Vatican hasn’t confirmed the trip.

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