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The purpose of this paper is to analyze from the street-level bureaucracy perspective, how health personnel manage the COVID-19 pandemic from the frontlines of hospitals in Mexico. A qualitative methodology was used based on the analysis of official documents as well as interviews and storytelling sessions with health personnel in charge of treating COVID-19 patients in public and private hospitals in Mexico. The analysis generated three themes about the decision-making process of health personnel derived from the COVID-19 pandemic: 1) the work conditions of health personnel were modified due to the hospital reconversion produced by the pandemic. 2) The triage and treatment of COVID-19 patients is heterogeneous because health personnel have discretion. And 3) Health personnel face conflicting work logics and contagion risk, which complicates their decision-making when treating COVID-19 patients. This study contributes to the growing literature on implementation, particularly of street-level bureaucracy, in the Mexican context. [ABSTRACT FROM AUTHOR]