Israeli forces have bombarded cities, towns and refugee camps across Gaza overnight and into Thursday, killing dozens of people.
The Israeli air and ground offensive against Hamas has widened to most of the territory and forced thousands more to flee from homes and shelters.
The war has already killed more than 20,000 Palestinians and driven around 85% of the population of 2.3 million from their homes.
Much of northern Gaza has been levelled, largely depopulated and isolated from the rest of the territory for weeks. Many fear a similar fate awaits the south.
Israel has vowed to dismantle Hamas – which is still putting up stiff resistance, even in the north – and bring back more than 100 hostages still held by the militants after their October 7 attack on southern Israel, in which some 1,200 people, mostly civilians, were killed.
Israel has brushed off international calls for a ceasefire, saying it would amount to a victory for Hamas.
The United States – while providing crucial support for the offensive – has urged Israel to take greater measures to spare civilians and allow more aid to reach people.
But aid workers say the amount of food, fuel and medical supplies entering is still far below what is needed, and one in four Palestinians in Gaza are starving, according to UN officials.
An Israeli air strike on a home in the northern town of Beit Lahiyeh – one of the first targets of the ground invasion that began in October – buried at least 21 people, including women and children, according to a family member.
Bassel Kheir al-Din, a journalist with a local TV station, said the strike flattened his family house and severely damaged three neighbouring homes.
He said 12 members of his family – including three children aged two, seven and eight – were buried and presumed dead, adding that nine neighbours were missing.
In central Gaza, Israeli war planes and artillery pounded the built-up Bureij and Nuseirat refugee camps, levelling buildings, residents said.
Israel said this week it would expand its ground offensive into central Gaza, and typically launches waves of air strikes and shelling before troops and tanks move in.
A hospital in the nearby town of Deir al-Balah received the bodies of 25 people killed overnight, including five children and seven women, hospital records showed on Thursday.
Non-stop explosions could be heard throughout the night in the town – where hundreds of thousands of people have sought shelter, with many spending the cold nights sleeping on pavements.
“It was another night of killing and massacres,” said Saeed Moustafa, a resident of the Nuseirat camp.
He said people were still crying out from the rubble of a house hit by an air strike on Wednesday.
“We are unable to get them out. We hear their screams but we don’t have equipment,” he said.
Further south, in Khan Younis, the Palestinian Red Crescent said a strike near its Al-Amal Hospital killed at least 10 people and wounded another 12.
Much of the city’s population has left, but many are sheltering near Al-Amal and another hospital, hoping they will be spared from the bombardment.
Rami Abu Mosab, who lives in the Bureij refugee camp, said thousands of people have fled their homes in recent days because of the intense bombardment. He plans to remain there because he doesn’t feel that anywhere in Gaza is safe.
“Here is death and there is death,” he said. “To die in your home is better.”
As Israel has broadened its offensive, fleeing Palestinians have packed into areas along the Egyptian border and the southern Mediterranean coastline, where shelters and tent camps are overflowing. Even in those areas, Israel continues to strike what it says are militant targets.
The Israeli military blames the high civilian death toll on Hamas, which positions fighters, tunnels and rocket launchers in dense residential areas. But the military rarely comments on individual strikes.
Israel’s offensive in Gaza has already been one of the most devastating military campaigns in recent history.
More than 21,100 Palestinians, most of them women and children, have been killed, according to the Health Ministry in Hamas-ruled Gaza. The count does not differentiate between civilians and combatants.
The Israeli military says it has killed thousands of militants, without presenting evidence, and that 167 of its soldiers have been killed in the ground offensive.