The World Health Organization has pleaded for fuel to be allowed into Gaza to keep its remaining hospitals running, warning the Palestinian territory's health system was at "breaking point".
"For over 100 days, no fuel has entered Gaza and attempts to retrieve stocks from evacuation zones have been denied," said Rik Peeperkorn, the WHO's representative in the Palestinian territories.
"Combined with critical supply shortages, this is pushing the health system closer to the brink of collapse."
Mr Peeperkorn said only 17 of Gaza's 36 hospitals were currently minimally to partially functional. They have a total of around 1,500 beds - around 45% fewer than before the conflict began.
He said all hospitals and primary health centres in north Gaza were currently out of service.
In Rafah in southern Gaza, health services are provided through the Red Cross field hospital and two partially-functioning medical points.
Speaking from Jerusalem, he said the 17 partially functioning hospitals and seven field hospitals were barely running on a minimum amount of daily fuel and "will soon have none left".
"Without fuel, all levels of care will cease, leading to more preventable deaths and suffering."
Hospitals were already switching between generators and batteries to power ventilators, dialysis machines and incubators, he said, and without fuel, ambulances cannot run and supplies cannot be delivered to hospitals.
Furthermore, field hospitals are entirely reliant on generators, and without electricity, the cold chain for keeping vaccines would fail.
"People often ask when Gaza is going to be out of fuel; Gaza is already out of fuel," said WHO trauma surgeon and emergency officer Thanos Gargavanis, speaking from Gaza.
"We are walking already the fine line that separates disaster from saving lives. The shrinking humanitarian space makes every health activity way more difficult than the previous day."
Israeli tank shelling kills 51 people
Meanwhile, Israeli tank shellfire killed at least 51 people as they awaited aid trucks in Khan Younis in southern Gaza, the territory's Hamas-run health ministry said, adding that dozens of others were wounded.
Medics said residents said Israeli tanks fired shells at crowds of desperate Palestinians awaiting aid trucks along the main eastern road in Khan Younis.
They said at least 51 people were killed and 200 wounded, with at least 20 of them in critical condition.
Witnesses said Israeli tanks fired at least two shells at thousands of people awaiting aid trucks. Nasser Hospital wards were crowded with casualties, and medical staff had to place some on the ground and in corridors due to the lack of space.
The incident was the latest in nearly daily mass deaths of Palestinians who were seeking aid in past weeks, including near sites operated by the US-backed Gaza Humanitarian Foundation.
Local health officials said at least 23 people were killed by Israeli gunfire yesterday as they approached a GHF aid distribution site in Rafah in southern Gaza.
The GHF stated in a press release last night that it had distributed more than three million meals at its four distribution sites without incident.
Israel has put responsibility for distributing much of the aid it allows into Gaza into the hands of the GHF, which operates sites in areas guarded by Israeli troops.
The United Nations has rejected the plan, saying GHF distribution is inadequate, dangerous and violates humanitarian impartiality principles.
The World Health Organization said it had received reports of a mass casualty incident that affected people waiting for food supplies.
"This is again the result of another food distribution initiative," said Thanos Gargavanis, WHO trauma surgeon and emergency officer, without giving further details.
"There's a constant correlation with the positions of the four announced food distribution sites and the mass casualty incidents," Mr Gargavanis added, saying the trauma injuries in recent days were mostly from gunshot wounds.
He also said that the WHO was running short of therapeutic supplies to treat malnutrition.
"We are running excessively low in therapeutic feeding formulas, and we're trying to rationalize its use," he said.
The latest bloodshed in the decades-old Israeli-Palestinian conflict was triggered in October 2023, when Palestinian Hamas militants attacked Israel, killing 1,200 and taking about 250 hostages, according to Israeli allies.
US ally Israel's subsequent military assault on Gaza has killed nearly 55,000 Palestinians, according to Gaza's health ministry, while internally displacing nearly Gaza's entire population and causing a hunger crisis.
The escalation is taking place as people in Gaza watch the exchange of attacks between Israel and Iran, which began with Israel launching major strikes on Friday.
Gazans have circulated images of wrecked buildings and charred vehicles hit by Iranian missiles in Israeli cities, and some were hopeful the wider conflict could eventually bring peace to the territory.
With Israel saying its operation could last weeks, fears have grown of a regional war dragging in outside powers.
Despite efforts by the United States, Egypt and Qatar to restore a ceasefire in Gaza, neither Israel nor Hamas has shown willingness to back down on core demands, with each side blaming the other for the failure to reach a deal.
Hamas leaders have repeatedly thanked Iran for its military and financial support to the group in its fight against Israel, including during the current war.
Shannon flight inspections
Separately, Social Democrats TD Gary Gannon has written to the EU's anti-fraud body, OLAF, regarding Ireland's failure to conduct risk-based inspections of flights linked to military contractors, dual-use goods and private jets travelling through Shannon en route to Israel.
He told the Dáil that Ireland is obliged under EU customs law to conduct such searches on known arms routes.
Deputy Gannon said that he had also written to the Attorney General here seeking legal clarity on the Government's position.
He told the Dáil that the "moral failure speaks for itself", adding the situation "potentially breaches EU VAT enforcement rules and raises serious questions under the Genocide Convention".
Additional reporting Paul Cunningham
