Since being hospitalized with acute pneumonia for two weeks, Pope Francis has signed off on the appointment of 20 bishops, accepted the resignations of at least four and approved moving five people along the road to sainthood, according to the daily bulletin on the Vatican website.

Some of the events noted were more esoteric, like his appointing a cardinal to represent him in April at the 1,000th anniversary celebration of the coronation of Boleslaw I the Brave, the first king of Poland.

Overall, the public tenor of the Holy See has changed absent its most public face and voice — lacking the weekly appearances of the pope and his pronouncements on important global issues, like rebuking the Trump administration over immigrant deportations. Yet the machinery of the Vatican state churns on even while the 88-year-old pontiff lies in a hospital with no discharge on the calendar.

“Francis is still governing, he is in contact with his aides,” Matteo Bruni, a Vatican spokesman, said in response to a question about the pope’s work. “What he is missing is the contact with the faithful, the general audiences, the pastoral activity.”

In a statement on Thursday evening, the Vatican said that the pope’s clinical condition continued to improve. He was alternating between using a high flow of oxygen and a ventilation mask, it said, and had spent the morning doing respiratory physiotherapy and resting, before an afternoon round of physiotherapy.

“In view of the complexity of the clinical picture, further days of clinical stability are required to determine the prognosis,” the Vatican statement said. The Vatican press office added that the pope was no longer considered in critical condition, but was still not out of danger.