Israel's ground troops advanced toward Gaza City on Thursday, as the US and Arab countries intensified diplomatic efforts to ease the siege of the Hamas-ruled enclave and bring about at least a brief stop to the fighting to help civilians.

More than 9,000 Palestinians have been killed since the war broke out, health officials said.

President Joe Biden suggested a humanitarian “pause” the day before, as an apparent agreement among the US, Egypt, Israel and Qatar, which mediates with Hamas, allowed hundreds of Palestinians with foreign passports and dozens of wounded to leave Gaza for the first time. Dozens more left on Thursday.

Arab countries, including those allied with the US and at peace with Israel, have expressed mounting unease with the war. Jordan recalled its ambassador from Israel and told Israel's envoy to remain out of the country until there's a halt to the war and the “humanitarian catastrophe” it is causing.

More than 3,600 Palestinian children have been killed in 25 days of fighting, and bombings have driven more than half the territory's 2.3 million people from their homes, while food, water and fuel run low.

Israeli troops pushed into Gaza in larger numbers over the weekend after three weeks of heavy airstrikes that have demolished entire neighbourhoods.

The war, the fifth and by far deadliest in Gaza, began when Hamas launched a bloody October 7 rampage into Israel, killing hundreds of men, women and children. Some 240 were captured.

The US has pledged unwavering support for Israel as it seeks to end Hamas' rule over Gaza and crush its military capabilities, even as the two allies seem to have no clear plan for what would come next.

White House officials said a pause in fighting would allow for more aid to be sent in and potentially facilitate the release of hostages. US Secretary of State Antony Blinken is expected back in the region on Friday.

The departure of Palestinians through the Rafah crossing into Egypt on Wednesday came after weeks of talks. It was first time people left Gaza other than four hostages released by Hamas and another rescued by Israeli forces. Israel has also allowed more than 260 trucks carrying food and medicine through the crossing, but aid workers say it's not nearly enough.

At least 335 foreign passport holders left Wednesday and approximately another 100 left Thursday, according to Wael Abu Omar, a spokesman for the Palestinian Crossings Authority. Seventy-six Palestinian patients, along with their companions, were also evacuated, he said.

The US has said it is trying to evacuate 400 Americans with their families.

Egypt has said it will not accept an influx of Palestinian refugees, fearing Israel will not allow them to return to Gaza after the war.

Hundreds of thousands of Palestinians remain in the path of the fighting in northern Gaza, despite Israel's repeated calls for them to evacuate to the territory's south, which is also being bombarded.

Israeli troops appear to be advancing on three main routes, according to the Institute for the Study of War, a US research group. One thrust came from Gaza's northeast corner. Another, south of Gaza City, cut across the territory, reaching the main north-south highway.

The third, from Gaza's northwest corner, has moved about 5 kilometers (3 miles) down the Mediterranean coast, reaching the outskirts of the Shati and Jabaliya refugee camps, on the edges of Gaza City.

Airstrikes on Tuesday and Wednesday destroyed apartment blocks in Jabaliya, but the number of dead and wounded remained unknown. Israel said the strikes killed militants and demolished Hamas tunnels.

Palestinian militants fired antitank missiles, set off explosive devices and hurled grenades at Israeli troops during an overnight battle, the Israeli military said Thursday. It said soldiers returned fire and called in artillery, as well as strikes from a helicopter and a naval ship. The report could not be independently confirmed.

Casualties on both sides are expected to rise as Israeli troops advance toward the dense residential neighbourhoods of Gaza City. Israeli officials say Hamas' military infrastructure, including tunnels, is concentrated in the city and accuse Hamas of hiding among civilians.

More than 9,000 Palestinians have been killed in the war, mostly women and minors, and more than 32,000 people have been wounded, the Gaza Health Ministry said on Thursday, without providing a breakdown between civilians and fighters. The figure is without precedent in decades of Israeli-Palestinian violence.

Four Palestinians, including three teenagers, were shot dead in different parts of the occupied West Bank early Thursday, the Palestinian Health Ministry said. More than 130 Palestinians have been killed in the West Bank since the start of the war, mainly in violent protests and gunbattles during Israeli arrest raids.

Over 1,400 people have died on the Israeli side, mainly civilians killed during Hamas' initial attack, also an unprecedented figure. Seventeen Israeli soldiers have been killed in Gaza since the start of the ground operation.

Rocket fire from Gaza into Israel, and daily skirmishes between Israel and Lebanon's Hezbollah militants, has disrupted life for millions of Israelis and forced an estimated 250,000 to evacuate towns near the borders in the north and south. Most rockets are intercepted or fall in open areas.

Those remaining in Gaza face an increasingly dire humanitarian situation, with basic supplies running low and hundreds of thousands packed into hospitals and UN-run shelters.

Hospitals say their emergency generators are running dangerously low on fuel amid a territory-wide blackout. The World Health Organization said the lack of fuel puts at risk 1,000 patients on kidney dialysis, 130 premature babies in incubators, as well as cancer patients and patients on ventilators.

Israel has refused to allow fuel in, saying it fears Hamas would steal it for military purposes. The military released a recording of what it said was a Hamas commander forcing a hospital to hand over some fuel. The recording could not be independently verified.

Only hours of electricity remained at Gaza City's largest hospital, Shifa, according to its director, Mohammed Abu Salmia, who pleaded for “whoever has a liter of diesel in his home” to donate it.

The Turkish-Palestinian Hospital, Gaza's only facility offering specialized treatment for cancer patients, was forced to shut down Wednesday because of lack of fuel, leaving 70 cancer patients in a critical situation, the Health Ministry said.

The Indonesian Hospital in northern Gaza, where many of those wounded in the Jabaliya strikes were being treated, was forced to turn off most lights and its mortuary refrigerators.

“These exceptional measures will allow the Indonesian Hospital to work for a few more days,” Health Ministry spokesman Ashraf al-Qudra said. “However, if we cannot secure electricity or fuel then we will face a disaster.”