Israel strikes near Gaza's largest hospital after accusing Hamas of using it as a base

Israeli warplanes carried out airstrikes early Sunday near Gaza's largest hospital, which is packed with patients and tens of thousands of Palestinians seeking shelter. Israel has said Gaza's Hamas rulers have a command post under the hospital, without providing much evidence.

The strikes came a day after Israeli Prime Minister Benjamin Netanyahu announced a "second stage" in Israel's war on Hamas, three weeks after Hamas launched a brutal incursion into Israel Oct. 7. Ground forces pushed into Gaza over the weekend as Israel pounded the territory from air, land and sea.

The bombardment — described by Gaza residents as the most intense of the war — knocked out most communications in the territory late Friday, largely cutting off the besieged enclave's 2.3 million people from the world. Communications were restored to many people in Gaza early Sunday, according to local telecoms companies, Internet-access advocacy group NetBlocks.org and confirmation on the ground.

Residents said the latest airstrikes destroyed most of the roads leading to Shifa Hospital in Gaza City, which is part of the northern half of the besieged territory, which Israel has told people to evacuate. Israel says most residents have fled to the south, but hundreds of thousands remain in the north, in part because Israel has also bombarded targets in so-called safe zones. Tens of thousands are sheltering in Shifa, which is also packed with patients wounded in strikes.

"Reaching the hospital has become increasingly difficult," Mahmoud al-Sawah, who is sheltering in the hospital, said over the phone. "It seems they want to cut off the area." Another Gaza City resident, Abdallah Sayed, said the Israeli bombing over the past two days was "the most violent and intense" since the war started.

The Israeli military had no immediate comment when asked about reports of strikes near Shifa.

The army recently released computer-generated images showing what it said were Hamas installations in and around Shifa Hospital, as well as interrogations of captured Hamas fighters who might have been speaking under duress. Israel has made similar claims before, but has not substantiated them.

Little is known about Hamas' tunnels and other infrastructure, and the claims could not be independently verified. Hamas' government dismissed the allegations as "lies" and said they were "a precursor for striking this facility."

On Saturday, the Israeli military released grainy images showing tank columns moving slowly in open areas of Gaza, apparently near the border, and said warplanes had bombed dozens of Hamas tunnels and underground bunkers.

The escalation ratcheted up domestic pressure on Israel's government to secure the release of some 230 hostages seized in the Oct. 7 rampage, when Hamas fighters stormed from Gaza into nearby Israeli towns and gunned down civilians and soldiers.

Desperate family members met with Netanyahu on Saturday and expressed support for an exchange for Palestinian prisoners held in Israel.

Hamas' top leader in Gaza, Yehia Sinwar, said the Palestinian groups "are ready immediately" to release all hostages if Israel releases all of the thousands of Palestinians held in Israeli prisons. Rear Adm. Daniel Hagari, an Israeli military spokesman, dismissed the offer as "psychological terror."

Netanyahu told the nationally televised news conference that Israel is determined to bring back all the hostages, and maintained that the expanding ground operation "will help us in this mission." He said he couldn't reveal everything that is being done due to the sensitivity and secrecy of the efforts.

"This is the second stage of the war, whose objectives are clear: to destroy the military and governmental capabilities of Hamas and bring the hostages home," he said in his first time taking questions from journalists since the war began.

Netanyahu also acknowledged that the Oct. 7 "debacle," in which more than 1,400 people were killed, would need a thorough investigation, adding that "everyone will have to answer questions, including me."

The Israeli military said it was gradually expanding its ground operations inside Gaza, while stopping short of calling it an all-out invasion.

"We are proceeding with the stages of the war according to an organized plan," Hagari, the military spokesman, said. The comments hinted at a strategy of staged escalation, instead of a massive and overwhelming offensive.

Despite the Israeli offensive, Palestinian fighters have continued firing rockets into Israel, with the constant sirens in southern Israel a reminder of the threat.

The Palestinian death toll in Gaza rose Saturday to just over 7,700 people since the war began, with 377 deaths reported since late Friday, according to the Gaza Health Ministry. Most of those killed have been women and minors, the ministry said.

Ministry spokesman Ashraf al-Qidra told reporters that the disruption of communications had "totally paralyzed" the health network. Residents had no way of calling ambulances, and emergency teams were chasing the sounds of artillery barrages and airstrikes.

An estimated 1,700 people remain trapped beneath the rubble, according to the Health Ministry, which has said it bases its estimates on distress calls it received.

Israel says its strikes target Hamas fighters and infrastructure and that the fighters operate among civilians, putting them in danger.

More than 1.4 million people across Gaza have fled their homes, nearly half crowding into UN schools and shelters, following repeated warnings by the Israeli military that they would be in danger if they remained in northern Gaza. No one has been allowed out of the sealed-off territory, where food and water were running out.

Humanitarian workers say the trickle of aid Israel has allowed to enter from Egypt in the past week is a tiny fraction of what is needed. Gaza hospitals have been scrounging for fuel to run emergency generators that power incubators and other life-saving equipment.

The overall number of deaths in Gaza and Israel far exceeds the combined toll of all four previous Israel-Hamas wars, estimated at around 4,000.

The conflict has threatened to ignite a wider war across the region. Arab nations — including U.S. allies and ones that have reached peace deals or normalized ties with Israel — have raised increasing alarm over a potential ground invasion.