The storming by Israeli troops of southern Gaza’s main hospital brought chaos to hundreds of staff and patients inside, as health officials on Friday said four people in intensive care died after their oxygen was cut off. Troops were searching the facility, where the military said it believes the remains of hostages abducted by Hamas might be located.

The raid came after troops had besieged Nasser Hospital in the southern city of Khan Younis for nearly a week, with staff, patients and others inside struggling under heavy fire and dwindling supplies, including food and water. Hours before troops seized the hospital on Thursday, Israeli fire killed a patient and wounded six others inside the complex, staff said.

Negotiations over a ceasefire in Gaza, meanwhile, appear to have stalled, and Israeli Prime Minister Benjamin Netanyahu on Friday pushed back hard against the US vision for after the war — particularly its calls for the creation of a Palestinian state. After speaking overnight with President Joe Biden, Netanyahu wrote on X that Israel will not accept “international dictates regarding a permanent settlement with the Palestinians”

He said that if other countries unilaterally recognise a Palestinian state, it would give a “reward to terrorism”.