I also thought he looked very tired, his hair looked unkept, and he generally did not carry himself as confidently or professionally as I have seen him in the past.
If he was a friend or family member of mine, today's appearance would have raised my concern for his health/emotional wellbeing right now. I just didn't think he looked or acted "well"..
No, he is one person who never feels well. He has to really use his upper chest and neck muscles to breathe and he seemed to be really tugging today. He has very little fine movements in his hands, you probably saw he got a little flustered when trying to turn pages while everyone was watching as he searched for a reference . Sad.