You can avoid needing to create global variables by using instance mode.
Try the following:
new p5((p) => {
let x = 100;
let img;
p.preload = () => {
img = p.loadImage("birch.png");
};
p.setup = () => {
p.createCanvas(400, 400);
};
p.draw = () => {
p.image(img,x,200,100,100);
};
});
See this reference material: