At least 50 people were killed by Israeli strikes and gunfire across Gaza today, including 39 in Gaza City, local health authorities have said, bringing the death toll from Israeli attacks on the territory to 65,000 since October 2023.
Palestinian officials and rescue workers say the true figure is likely to be higher as many people's remains are trapped under the rubble of destroyed buildings.
Health authorities in Gaza also reported a drone attack on a specialist children's hospital, which did not cause casualties but forced young patients and their families outside.
It comes as the Israeli military said it was opening an additional route for 48-hours that Palestinians could use to leave Gaza City as it stepped up efforts to empty the city of civilians and confront thousands of Hamas combatants.
Hundreds of thousands of people are sheltering in the city, and many are reluctant to follow Israel's orders to move south because of the dangers along the way, such as dire conditions and a lack of food in the southern area as well as a fear of permanent displacement.
"Even if we want to leave Gaza City, is there any guarantee we would be able to come back? Will the war ever end? That's why I prefer to die here, in Sabra, my neighbourhood," Ahmed, a schoolteacher, said by phone.
Gaza health authorities said an Israeli drone had dropped grenades on one floor of the Rantissi children's hospital.
No casualties were reported but the ministry said some 40 families took their children away.
"This hospital is the only specialist facility for children with cancer, kidney failure, and other life-threatening conditions – but even these gravely ill children are not spared from relentless bombardment," said Fikr Shalltoot, Gaza director at the UK-based charity Medical Aid for Palestinians.
The Gaza media office says 190,000 people have headed south from Gaza City and 350,000 have moved to central and western areas of the city.
A day after Israel announced the launch of its ground offensive to seize control of Gaza's main urban centre, tanks had moved short distances towards the city's central and western areas from three directions, but no major advance was reported.
An Israeli official claimed military operations were focused on getting civilians to head south and that fighting would intensify over the next month or two.
Hamas official speaks out
Defying global criticism of the attack, including a rebuke by Israel's stalwart ally, the United States, Prime Minister Benjamin Netanyahu has said Israel would strike Hamas leaders anywhere.
Ghazi Hamad, a top official in Hamas, appeared in a live interview broadcast by Qatari channel Al Jazeera, in the first appearance of a Hamas leader since the Israeli attack on Doha on 9 September.
The attack occurred "less than an hour after we began studying the proposal" for a ceasefire in Gaza, he said, referring to a meeting of senior Hamas officials he specified was discussing a US proposal delivered to them via Qatar.
"The rockets came down consecutively, without a pause, around 12 missiles in less than a minute," he added, saying the group "learned with complete certainty that it is an Israeli attack".
"God destined us to survive this treacherous aggression against us and sister Qatar," he said.
According to sources close to Hamas, Mr Hamad was one of six leaders of the Palestinian Islamist movement gathered in the building targeted by Israel at the time of the strike, along with chief negotiator Khalil al-Hayya, former chief Khaled Meshaal, West Bank head Zaher Jabarine and political bureau members Bassem Naim and Taher al-Nounou.
Mr Hayya's son was killed in the Israeli strike, and Hamas has since said that the chief negotiator himself is alive, but has not provided proof.
Read more: Latest Middle East stories
In leaflets dropped over Gaza City, the military said Palestinians could use the newly reopened Salahudin Road to escape towards the south and that they had until lunchtime on Friday to do so.
But the situation remained chaotic and dangerous for civilians, who have been streaming away on foot, by donkey cart or in vehicles in recent days.
Much of Gaza City was laid to waste early in the war in 2023, but around one million Palestinians had returned there to homes among the ruins.
Forcing them out would mean confining most of Gaza's population to overcrowded encampments in the south where a hunger crisis is unfolding.
The United Nations, aid groups and foreign governments have condemned Israel's offensive and the proposed mass displacement.
Israeli forces control Gaza City's eastern suburbs and have been pounding three areas in the southeast, north and northwestern coastal areas of the city, from which tanks have been pressing towards the centre and western areas.
"Gaza is being wiped out. A city that is thousands of year sold is being wiped out in front of the whole cowardly world," said Ahmed, the schoolteacher.
In Nuseirat refugee camp in the enclave's centre, an airstrike destroyed a high-rise building, prompting residents of nearby buildings to flee in panic.
Palestinian and UN officials say no place is safe, including in the southern area designated by Israel as a "humanitarian zone".
Yesterday, an airstrike killed five people in a vehicle as they were leaving Gaza City for the south.
The current stage of the war was triggered by Hamas-led attacks on southern Israel on 7 October 2023, in which about 1,200 people were killed and 251 taken hostage, according to Israeli tallies.
UN investigators say Israel committing genocide
The UN Independent International Commission of Inquiry (COI), which does not speak for the world body, found that genocide is occurring in Gaza and is continuing to occur, commission chief Navi Pillay said.
Qatar became the latest country to urge Israel to stop its assault on Gaza City, calling it "an extension of its genocidal war against the Palestinian people".
France issued a similar call, saying the "destructive campaign... no longer has any military logic" and appealing for a resumption of ceasefire talks.
Israel carried out strikes against Hamas leaders in Doha on 9 September, killing five of the Palestinian militant group's members and a Qatari security officer.
Yesterday, during a visit to Doha, US Secretary of State Marco Rubio met Qatar's emir, Sheikh Tamim bin Hamad Al Thani, to ask the Gulf country to stay on as a mediator in the Gaza talks.
Read more: How did UN commission reach its genocide conclusion?
Catholic priest in Gaza City tells of danger and fear
Plight of Palestinians in Gaza 'unacceptable' - Pope
Pope Leo has denounced the "unacceptable" conditions faced by Palestinians in Gaza, voicing solidarity with civilians and renewing his appeal for a ceasefire in the war between Israel and Hamas.
"I express my deep closeness to the Palestinian people in Gaza, who continue to live in fear and survive in unacceptable conditions, forced once again to leave their land," the pope said in his weekly general audience at the Vatican.
The pope renewed his call for a truce, for the freeing of hostages held in Gaza, and for a negotiated diplomatic solution to the conflict.
He urged the faithful to join him in prayer "that a dawn of peace and justice may soon arise".
Leo, elected the first US pope in May, has been stepping up his calls for a halt to the war in Gaza in recent weeks.
Earlier this month, the pope met Israeli President Isaac Herzog at the Vatican.
In an unusually lengthy statement afterwards, the Vatican said Leo had lamented the "tragic situation in Gaza" with Mr Herzog.
