Vladimir Putin has been filmed nodding off during a council meeting over tourism in Russia having reportedly talked to doctors about struggling with “fatigue and shortness of breath”.
The Russian president looked tired, as he and other officials appeared to fall asleep while listening to speeches - fuelling more questions over his state of health.
He had “complained to doctors about fatigue and shortness of breath” on his mammoth trip to the Russian far east, it is claimed.
And the council meeting to discuss tourism, held off Russky island, near Vladivostok appeared too much for Putin who struggled to keep his eyes open.
A body double or “doppelgänger” is allegedly on standby in case he feels unable to fulfil his engagements.
Putin has also been supervising the Vostok-2022 war games in the Pacific after visiting the glaciers-and-volcanoes peninsula Kamchatka.
Telegram channel General SVR - which has long claimed Putin is suffering serious health issues - said he had gone ahead with the gruelling trip despite medical setbacks.
“Even before the flight to Kamchatka, President of Russia Vladimir Putin had worsening problems with his kidneys, swelling of his face appeared, [and] ’bags’ under his eyes clearly appeared,” stated the channel.
“Despite the use of drugs, there was no clear improvement. Upon arrival in Kamchatka, Putin complained to doctors about fatigue and shortness of breath.
“But the president nevertheless decided to participate in pre-planned activities. [A] doppelgänger of the President is ready to assist."
On his visit to Kamchatka, the 69-year-old leader's feet were seen "twitching uncontrollably", and he awkwardly clasped a chair at one point.
He also appeared puffy-faced and seemed to have difficulty speaking at times with his voice croaky.
General SVR channel has claimed that Putin is suffering from serious illnesses including cancer and Parkinson's disease but it has not provided proof.
It is reportedly authored by an exiled Kremlin lieutenant-general, who is known by the alias Viktor Mikhailovich, and claims inside knowledge.
But Russian officials deny he has health issues.
Putin did admit that officials had considered using doubles two years ago although the idea was rejected.
"I discarded the idea of any doubles,” he said.
He was advised in the early 2000s when Russia was hit by terrorist attacks that a lookalike should take his place at events where the head of state might be at risk, he said.
“This was during the toughest time of our war against terrorism,” he said.
Body doubles were used by former Kremlin leaders, for example long time Soviet supremos Josef Stalin and Leonid Brezhnev.