Israel launched its long-anticipated ground offensive in Gaza City Tuesday, targeting Hamas fighters and prompting widespread international alarm, with the UN condemning it as "carnage".
A United Nations probe charged Israel with committing "genocide" in the Palestinian territory and accused Prime Minister Benjamin Netanyahu and other senior officials of incitement.
The Israeli military unleashed a massive bombardment of Gaza City overnight as its troops moved deeper into the territory's largest urban hub.
"Over the past 24 hours, following extensive discussions with the political echelon, the IDF (military) has significantly expanded its operation in Gaza City," said army chief Lieutenant General Eyal Zamir.
"We are operating deep in the area, combining ground troops, precision strikes and high-quality intelligence. Our objective is to enhance the strikes on Hamas until its decisive defeat."
UN chief Antonio Guterres said Israel was "determined to go up to the end".
Israel was "not open to a serious negotiation for a ceasefire, with dramatic consequences from Israel's point of view," he said.
The military estimated there were 2,000-3,000 Hamas fighters in central Gaza City, an army official told journalists.
It said about 40% of Gaza City residents had left and moved to the territory's south, the official added.
An AFP journalist saw many people, including children, sleeping in front of a hospital in Gaza City after fleeing from their homes.
"The people do not have money to move to the south or even to move internally," said Youssef Shanaa, who had taken refuge at a hospital.
People spoke of relentless bombing in Gaza City, much of which is already in ruins after nearly two years of Israeli strikes.
Only huge piles of rubble remained of a residential block in the north of the city hit by overnight bombing.
"Why kill children sleeping safely like that, turning them into body parts?" said Abu Abd Zaquout. "We pulled the children out in pieces."
The assault was "systematic ethnic cleansing targeting our people in Gaza", Hamas said in a statement.
US President Donald Trump accused Hamas of using hostages as human shields.
"I hear Hamas is trying to use the old human shield deal, and if they do that they're going to be in big trouble," he said.
Israel struck Yemen's Houthi-held Hodeidah port Tuesday, saying it targeted a military infrastructure site of the rebel group, which has fired missiles at Israel since the outbreak of war in Gaza.
Later the military said it intercepted a missile launched from Yemen.
Gaza's civil defence, a rescue force operating under Hamas authority, said at least 44 people had been killed by Israeli fire Tuesday.
Media restrictions in the territory and difficulties in accessing many areas mean AFP is unable to independently verify the details provided by the civil defence or the Israeli military.
The European Union said the assault on Gaza City would worsen an already "catastrophic" humanitarian situation, while Britain said it would bring only "more bloodshed, kill more innocent civilians and endanger the remaining hostages".
Despite the growing criticism, US Secretary of State Marco Rubio, who visited Israel at the weekend, offered robust backing for the offensive as he met Netanyahu.
"We think we have a very short window of time in which a deal can happen. We don't have months anymore, and we probably have days and maybe a few weeks to go," he told reporters as he left Israel Tuesday.
Before flying out to Qatar, the top US diplomat said he hoped the US ally would keep up its Gaza mediation efforts, despite Israel carrying out air strikes against Hamas leaders gathered in the Gulf country last week to consider a US truce proposal.
Rubio's visit came a week before France was set to lead a UN summit in which several Western governments, angered by what they see as Israeli intransigence, plan to recognise a Palestinian state.
Displaced Palestinians move with their belongings southwards on a road in the Nuseirat refugee camp area in the central Gaza Strip following renewed Israeli evacuation orders for Gaza City, Tuesday
Smoke rises from Gaza after an explosion, as seen from the Israeli side of the border with Gaza, Tuesday.