Israeli forces are intensifying their attacks on the outskirts of Gaza City, residents say, as the military steps up preparations for a ground offensive to conquer it.
Hospitals said women and children were among more than 30 Palestinians killed in Israeli strikes in the city on Wednesday, most of them in the north and west.
The Israeli military's chief of staff vowed to continue striking Hamas's centres of gravity until it is defeated and its hostages freed.
The UN and aid groups said the Israeli operations were already having horrific humanitarian consequences for displaced families sheltering in the city, which is home to a million people and where a famine was declared last month.
Meanwhile, Israeli protesters took part in what they called a day of disruption to press their government to immediately agree a deal that would end the war in return for the release of all 48 Israeli and foreign hostages in Gaza, 20 of whom are believed to be alive.
Hospital officials said Israeli strikes and gunfire across the Gaza Strip had killed at least 46 people since midnight, with Gaza City's Shifa hospital reporting 21 bodies received from targeted strikes.
One strike resulted in the deaths of a family, including the parents and two sisters of three-year-old Ibrahim al-Mabhuh, who was found buried beneath rubble, the sole survivor according to his grandmother.
Reports have surfaced indicating Israeli military operations have also targeted schools serving as shelters for the displaced, raising concerns over escalating civilian danger amid continued conflict.
The humanitarian plight is exacerbated by the displacement of over 82,000 people since mid-August, as many families struggle to find safe shelter and basic necessities amidst ongoing airstrikes.
Relatives of hostages decry the government’s decision to intensify military operations, worried it may further jeopardize their loved ones’ safety following the breakdown of ceasefire talks last July.
The ongoing conflict, which reignited after Hamas's attack on southern Israel, has resulted in significant casualties on both sides, and the situation remains critical for the civilian population of Gaza.