Israel has bombarded Gaza, hitting areas in the south where Palestinians had been told to seek safety, as it began evacuating a large Israeli town in the north near the Lebanese border.
The move is the latest sign of a potential ground invasion of Gaza that could trigger even more regional turmoil.
Palestinians in Gaza reported heavy air strikes in Khan Younis in the south, and ambulances carrying men, women and children streamed into the town’s Nasser Hospital, Gaza’s second-largest, which is already overflowing with patients and people seeking shelter.
Officials have given no timetable for such an operation.
Over a million people have been displaced in Gaza, with many heeding Israel’s orders to evacuate the northern part of the sealed-off coastal enclave.
Gaza’s overwhelmed hospitals are rationing their dwindling medical supplies and fuel for generators, as authorities worked out logistics for a desperately needed aid delivery from Egypt that has yet to enter.
The deal to get aid into Gaza through Rafah, the territory’s only crossing not controlled by Israel, remains fragile.
Israel said the supplies could only go to civilians and that it would “thwart” any diversions by Hamas.
Israel has evacuated its own communities near Gaza and Lebanon, putting residents up in hotels elsewhere in the country in a state-funded programme.
On Friday, the defence ministry announced evacuation plans for Kiryat Shmona, a town of more than 20,000 residents near the Lebanese border.
Meanwhile, an unclassified US intelligence assessment delivered to congress estimated casualties in an explosion at a Gaza City hospital this week on the “low end” of 100 to 300 deaths.
The death toll “still reflects a staggering loss of life”, said the report, seen by The Associated Press.
The report echoed earlier assessments by US officials that the blast at the al Ahli hospital was not caused by an Israeli air strike, as the Hamas-run health ministry in Gaza initially reported.
Israel has presented video, audio and other evidence it says proves the blast was caused by a rocket misfired by Palestinian militants.
The AP has not independently verified any of the claims or evidence released by the parties.
An Israeli airstrike hit a Greek Orthodox church housing displaced Palestinians near the hospital late Thursday. The Israeli military said it had targeted a Hamas command and control centre nearby, causing damage to a church wall. In the immediate aftermath, Palestinian medics gave conflicting accounts of the number of wounded.
The Israeli military has relentlessly attacked Gaza in retaliation for the devastating October 7 Hamas attack. Even after Israel ordered a mass evacuation to the south, strikes extended across the territory, heightening fears among the territory’s 2.3 million people that nowhere is safe.
Palestinian militants have meanwhile fired daily rocket barrages into Israel from Gaza, and tensions have flared in the Israeli-occupied West Bank, where 13 Palestinians, including five minors, were killed on Thursday during a battle with Israeli troops in which Israel called in an air strike, according to the Palestinian health ministry.
The Gaza health ministry said 3,785 people have been killed in Gaza since the war began, the majority women, children and older adults. Nearly 12,500 were injured, and another 1,300 people were believed buried under rubble, authorities said.
In a fiery speech to Israeli infantry soldiers on the Gaza border, Mr Gallant, the defense minister, urged the forces to “be ready” to move in. Israel has massed tens of thousands of troops along the border.
“Whoever sees Gaza from afar now, will see it from the inside,” he said. “It might take a week, a month, two months until we destroy them,” he added, referring to Hamas.
With supplies running low because of a complete Israeli siege, some Gaza residents are down to one meal a day and drinking dirty water.