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Alarm has grown over spiraling Palestinian deaths and deepening misery for civilians from weeks of Israeli bombardment and a widening ground assault that risks even greater casualties. Overwhelmed hospitals say they are nearing collapse, with medicine and fuel running low under the Israeli siege. About 1.5 million people in Gaza, or 70% of the population, have fled their homes, the United Nations said Friday.

Palestinians are increasingly desperate for the most basic supplies.

The average Gaza resident is now , much of it made from stockpiled U.N. flour, said Thomas White, Gaza director for the U.N. agency for Palestinian refugees. Demands for drinking water are also growing.

“People are beyond looking for bread,� he told U.N. diplomats in a video briefing from Gaza. "It’s looking for water.�

After talks with Netanyahu, Blinken said a temporary halt was needed to boost aid deliveries and help win the release of the hostages Hamas took during its brutal incursion.

But Netanyahu said he told Blinken that Israel was “going with full steam ahead" unless hostages are released.

U.S. officials initially said they were not seeking a cease-fire, but rather short pauses in specific areas to allow aid deliveries or other humanitarian activity, after which Israeli operations would resume. Netanyahu has not publicly addressed the idea and has instead repeatedly ruled out a cease-fire.

On Friday, however, a senior U.S. administration official said policymakers believe a “fairly significant pause� in fighting will be needed to allow for releases. The idea is modeled on a smaller-scale pause that allowed the from Hamas captivity in October.

The official, speaking on condition of anonymity to discuss the matter, said that release was a test pilot for how a broader deal could be struck, and said negotiations on a “larger package� of hostages are ongoing. The official emphasized it would require a significant pause in fighting to ensure their safety to the Gaza border.

GAZA CITY ENCIRCLED

Israeli troops of Gaza City amid continued battles with as airstrikes wreaked havoc around the city, the largest in the tiny Mediterranean territory.

Al Jazeera TV reported that a strike late Friday hit a school in Gaza City where many were taking refuge, causing casualties.

Strikes hit near the entrances of three hospitals in northern Gaza just as staff were trying to evacuate wounded to the south, hospital directors said. Footage showed the aftermath outside Gaza's largest hospital, Shifa, where more than a dozen bloodied bodies were strewn next to damaged cars and ambulances. One bleeding boy screamed as he huddled on top of a woman sprawled on the pavement.

Friday’s strike outside Shifa Hospital came after Israel said Hamas has a command center there — a claim that could not be independently verified and that Hamas and hospital officials deny.

At least 15 people were killed and 60 wounded outside Shifa Hospital, said Health Ministry spokesperson Ashraf al-Qidra. At least 50 others were killed or wounded in a strike outside Gaza's Indonesian Hospital, its director said, without providing more precise figures.

The Israeli military said its aircraft hit an ambulance Friday that Hamas fighters were using to carry weapons. The claim could not be independently verified. It was not clear whether the strike was connected to the one by Shifa Hospital. The military said it took place “near a battle zone,� suggesting it was close to ongoing ground battles.

Al-Qidra said a convoy of ambulances left Shifa carrying wounded people to Rafah when a strike hit a vehicle on the edges of Gaza City. The convoy turned around, and another strike hit another ambulance. He denied that any of the ambulances were used by Hamas fighters.

FEARS OVER NEW FRONTS

Throughout the war, Israel and Hezbollah have traded fire almost daily along the Lebanon border, raising fears of a new front opening there.

In his first public speech since the war began, Hezbollah leader said the cross-border fighting showed his group had “entered the battle.�

He suggested escalation was possible: “We will not be limited to this.� But he gave little sign that Hezbollah would fully engage in the fighting. So far, Hezbollah has to show backing for Hamas without igniting an all-out war that would be devastating for Lebanon and Israel.

“We are in a high state of readiness in the north, in a very high state of alert,� said Israeli military spokesperson Rear Adm. Daniel Hagari.

The exchanges since the start of the war have killed 10 Lebanese civilians and 66 fighters from Hezbollah and other militant groups, as well as seven Israeli soldiers and a civilian in northern Israel. Thursday saw one of the heaviest exchanges over the border yet when attacked Israeli military positions in northern Israel with drones and mortar fire, and Israeli warplanes and helicopter gunships retaliated with strikes in Lebanon.

WHERE THINGS STAND

More than 9,200 Palestinians have been killed in Gaza so far, including , said, without providing a breakdown between civilians and fighters.

More than 1,400 people have died on the Israeli side, mainly civilians killed during Hamas’ initial attack. Rocket fire by Gaza militants into Israel persists, disrupting life for millions of people and forcing an estimated 250,000 to evacuate. Most rockets are intercepted.

Twenty-four Israeli soldiers have been killed in Gaza since the start of the ground operation.

The overall toll is likely to rise dramatically. Israeli military officials said their forces have encircled densely built-up Gaza City and began Friday to launch targeted attacks within the city on militant cells.

and across northern Gaza. Israel says Hamas has extensive military infrastructure in the city, including a network of underground tunnels, bunkers and command centers. It says its strikes target Hamas and the militants endanger civilians by operating among them.

The military said its troops have killed numerous Hamas militants exiting tunnels. Footage released by the military showed soldiers and tanks advancing toward bombed-out buildings.

Israel has repeatedly told residents of Gaza's north to evacuate to the south for greater safety. But many have been unable to leave or to stay in the south, fearing continued airstrikes there.

The military on Thursday told residents to evacuate the Shati refugee camp on Gaza City’s edge. On Friday, shells hit a convoy of evacuees on the coastal road they were told to use, killing around a dozen people, doctors said. Footage from the road showed dead children lying in the sand.

Further south, in Khan Younis, workers pulled 17 bodies from the rubble of a building leveled by a strike, witnesses said. Associated Press images showed rescuers digging with their bare hands to save someone buried, with one arm protruding from the wreckage. At a hospital, a crying man held up the dead body of a small girl whose lower limbs appeared to be missing.

Heading into Friday morning in the occupied West Bank, Israeli forces killed seven Palestinians and arrested many more, according to the Israeli military and Palestinian health officials.

More than 386 Palestinian into Egypt on Friday, according to Wael Abou Omar, the Hamas spokesperson for the Rafah border crossing. That brings the total who have gotten out since Wednesday to 1,115.

Israel has allowed more than 300 trucks carrying food and medicine into Gaza, but aid workers say it’s not nearly enough. Israeli authorities have refused to allow fuel in, saying Hamas is hoarding fuel for military use and would steal new supplies.

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Mroue reported from Beirut. Keath reported from Cairo. Associated Press writers Jack Jeffrey in Cairo, Julia Frankel in Jerusalem, Zeke Miller in Washington, and Matthew Lee in Tel Aviv, Israel, contributed to this report.

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