Russia has offered North Korea Covid vaccines once again, amid reports that a harsh lockdown is leading to extreme hunger.
Pyongyang has refused vaccines and aid from a number of countries.
It has instead sealed borders to try and keep the virus out but that has affected trade with China. It relies on Beijing for food, fertiliser and fuel.
Kim Jong-un has acknowledged that the country is facing food shortages, describing the situation as “tense”.
He made the comments last month and also told citizens to prepare for the “worst ever outcome” which has invoked comparisons to a deadly famine in the 1990s.
International trade sanctions are believed to have further put pressure on food supplies.
The UN Food and Agriculture Organization (FAO) has said that the country could face significant shortages as early as next month.
In a report the FAO projects North Korea will not be able to produce enough grain to feed its population this year.
Without “commercial imports and/or food aid, households could experience a harsh lean period from August to October,” the UN body said.
Russia has previously told North Korea that “not everyone can endure unprecedentedly strong, overarching restrictions”, and on Wednesday Russian Foreign Minister Sergey Lavrov said that Moscow has offered Pyongyang vaccines on a number of occasions.
He also repeated the offer to provide vaccines should the country require them.
North Korea says it has no Covid cases, a claim doubted by experts.
Last week a high ranking official was fired over an unspecified “grave incident” believed to be related to the virus.
North Korean media later named him as Ri Pyong Chol, a top-ranking military official.
Kim Jong-un also berated top officials over lapses related to Covid-19, North Korean state media report last month.
It was a rare sign of the pandemic’s severity in North Korea.
State news outlet KCNA said Mr Kim accused senior officials of negligence at a specially convened meeting of party leaders.
As a result, they “caused a grave incident that has caused a great risk to people and the nation’s safety”, according to his comments in Korean.
Without vaccines, it is unclear how or when North Korea will be able to ease border restrictions and allow food and aid into the country.
China and South Korea are among a number of countries that have previously offered jabs to Pyongyang.
There is some doubt however, over the country’s capacity to store and distribute them.
Global vaccine sharing initiative Gavi said in May that it had indefinitely delayed a shipment of nearly 2 million AstraZeneca vaccines to North Korea, citing a lack of “technical preparedness”.