Israel announced its worst combat losses for more than a month on Wednesday after an ambush in the ruins of Gaza City, and faced growing diplomatic isolation as civilian deaths mounted and a humanitarian catastrophe worsened.
Intense fighting was under way simultaneously in the north and south of the enclave, a day after the United Nations demanded an immediate humanitarian ceasefire. U.S. President Joe Biden said Israel's "indiscriminate" bombing of civilians was costing international support.
Warplanes again bombed the length of Gaza and aid officials said the arrival of rainy winter weather worsened the conditions for hundreds of thousands of families sleeping rough in makeshift tents. The vast majority of Gaza's 2.3 million people have already been made homeless.
Israel launched its campaign to annihilate the Hamas group that controls Gaza with global sympathy after fighters stormed across the border fence on Oct. 7, killing 1,200 Israelis, mostly civilians, and seizing 240 hostages.
But since then, Israeli forces have besieged the enclave and laid much of it to waste, with more than 18,000 people confirmed killed according to Palestinian health authorities, and many thousands more feared lost in the rubble or beyond the reach of ambulances.
In Rafah, at the southern end of the Strip where hundreds of thousands of people have sought shelter, the bodies of a family killed in an overnight air strike were being laid out in the rain in bloodied white shrouds, including several small children. One, only the size of a newborn, was wrapped in a pink blanket.
Ahmed Abu Reyash collected the bodies of his nieces, Sama and Sara, aged 5 and 7. As he walked through the street carrying one of the girls, a relative tugged at the shroud and shouted: "These are children! Children! Do they kill anyone other than children? No! These are innocents! They killed them with their dirty hands!"
Since a week-long truce collapsed at the start of December, Israeli forces have extended their ground campaign from the northern Gaza Strip into the south with the storming of the main southern city of Khan Younis.
Meanwhile, fighting has only intensified amid the rubble of the north, where Israel had previously claimed its military objectives had been largely met.
Israel reported ten of its soldiers killed in the past 24 hours, including a full colonel commanding a forward base and a lieutenant-colonel commanding a regiment. It was the worst one-day loss since 15 were killed on Oct. 31.
Most of the deaths came in the Shejaiya district of Gaza City in the north, where troops were ambushed trying to rescue another group of soldiers who had attacked fighters in a building, the military said.
Hamas said the incident showed that Israeli forces could never subdue Gaza: "The longer you stay there, the greater the bill of your deaths and losses will be, and you will emerge from it carrying the tail of disappointment and loss, God willing."
In the north, heavy fighting has also taken place in the Jabaliya district, where Gaza health officials say Israeli forces have besieged and stormed a hospital and detained and abused medical staff.
In the south, Israeli forces storming Khan Younis advanced in recent days to city centre. Residents said there was heavy fighting there but no further attempts to advance in the last 24 hours.
"The Israeli tanks have not moved further from the centre of the city. They are facing fierce resistance and we hear the exchanges of fire, explosions too," Abu Abdallah, a father of five who lives 2 km away, told Reuters.
The Israelis had brought bulldozers and were destroying the road near the Khan Younis home of the Hamas leader in Gaza, Yahya Al-Sinwar, Abu Abdallah said.
Hospitals in the north have largely ceased functioning altogether. In the south, they have been overrun by dead and wounded, carried in by the dozen throughout the day and night.
"Doctors including myself are stepping over the bodies of children to treat children who will die," Dr Chris Hook, a British physician deployed with medical charity MSF at Nasser hospital in Khan Younis, told Reuters.
International agencies say the limited aid reaching Gaza is being distributed only in parts of Rafah near the Egyptian border. Even there, the situation has become far more extreme this week.
Gemma Connell, based in Rafah as Gaza team leader for the U.N. humanitarian office OCHA, told Reuters in a message: "Heavy rains and winds overnight. So awful for all of these people in makeshift shelters."
Israel says it has been encouraging increased aid to Gaza through Egypt's border, and is announcing daily four-hour pauses in operations near Rafah to help civilians reach it. The U.N. says cumbersome inspections and insecurity have slowed aid to a trickle.
The U.N. General Assembly vote demanding a ceasefire has no legal force but was the strongest sign yet of eroding international support for Israel's actions. Three-quarters of the 193 member states voted in favour and only eight countries joined the United States and Israel in voting against.
Before the vote, Biden said Israel still has support from "most of the world" for its fight against Hamas.
"But they're starting to lose that support by indiscriminate bombing that takes place," he told a campaign donor event.
In the most public sign of division between the U.S. and Israeli leaders so far, Biden said Prime Minister Benjamin Netanyahu needed to change his hardline government, and that ultimately Israel "can't say no" to an independent Palestinian state, opposed by far-right members of the Israeli cabinet.
