At least 500 people were killed by an explosion at a hospital in Gaza City on Tuesday that Palestinian authorities said was caused by an Israeli airstrike.

The Palestinian health ministry said the number of casualties was expected to rise. Many civilians were sheltering at the Ahly Arab Hospital, better known as Al-Ma’amadani, before it was hit. Israel said it was investigating the report.

The deadly strike on the hospital came as US President Joe Biden was preparing for a visit to Israel on Wednesday as conditions in besieged Gaza grew ever more desperate. What little remains of the enclave’s food, fuel and water supplies were dwindling fast on Tuesday and hundreds of thousands of people were on the move, fleeing the strip’s northern half to escape a planned Israeli ground invasion.

Israel has blocked basic necessities from reaching Gaza and has launched daily airstrikes in retaliation for the October 7 cross-border attacks, in which 1,400 Israelis died and 200 people were taken hostage by the Hamas militants who control the enclave.

By Tuesday, the consequences of the blockade and strikes were inescapable: Rescuers were struggling to free some 1,200 people trapped under rubble, fights were breaking out over loaves of bread and hospitals were grappling with how to treat the rapidly growing number of wounded and ill as their generators ran short of fuel. Palestinian officials said that at least 2,800 people had been killed and 10,000 others had been wounded in the Israeli strikes.

With the humanitarian crisis deepening, pressure mounted to immediately provide safety and aid to Gaza’s two million residents. Yet American-led diplomatic efforts have so far yielded few results. Days of efforts to get aid through Egypt’s border with Gaza have failed to bear fruit.

Early on Tuesday morning, the US again expressed hope that it was close to an aid agreement and to establishing safe zones in southern Gaza, where the United Nations said that 600,000 Palestinians had fled after Israel warned them to leave the north.

But Israeli forces have continued launching airstrikes into southern Gaza. Gaza’s interior ministry said that at least 72 people were killed and dozens more were wounded in attacks on residential buildings in the cities of Khan Younis and Rafah. The Israeli military said on Tuesday morning that it had struck Hamas targets.

New York Times News Service