An Israeli airstrike hit a hospital in Gaza City where many civilians were sheltering, killing at least 500 people, according to Palestinian officials.

Here’s the latest on the war.

Hundreds of people were killed by an explosion at a hospital in Gaza City on Tuesday night where thousands of civilians had been sheltering, a loss of life that ignited protests across the Arab world on the same day President Biden left for Israel.

The Gazan health authorities said the blast had been caused by an Israeli airstrike; the Israel Defense Forces said it was caused by a rocket fired by a Palestinian armed group that malfunctioned after launching. Neither assertion could be immediately verified.

The health ministry in Gaza said the number of casualties was expected to rise. Many civilians were sheltering at Ahli Arab Hospital, better known as Al-Ma’amadani, before it was hit. The Civil Defense in Gaza said medical teams were overwhelmed and unable to respond adequately because the hospital was so badly damaged.

The explosion left a grisly aftermath, according to videos verified by The New York Times and photographs distributed by news agencies. Bloodied and charred bodies were strewn across the courtyard of the hospital. Blankets, backpacks and mattresses lay nearby, traces of families who had come to seek refuge at the hospital after their homes were destroyed.

Medics and civilians rushed people to Shifa Hospital, which, already at the verge of collapse itself, could hardly handle the influx of the wounded and the bodies of victims.

“I can’t describe what I saw. I swear to God — I witnessed the killing of my family, but I couldn’t even handle what I saw today,” Ali Jadallah, a longtime war photographer who visited the Shifa Hospital, said in a voice message. “I can’t handle what is happening.”

The deadly blast at the hospital came as conditions in besieged Gaza grew ever more desperate. What little remains of the enclave’s food, fuel and water supplies was dwindling fast on Tuesday, and hundreds of thousands of people were on the move, fleeing the strip’s northern half to escape a planned Israeli ground invasion.

Israel has blocked basic necessities from reaching Gaza and has launched daily airstrikes in retaliation for the Oct. 7 cross-border attacks, in which 1,400 Israelis died and 200 people were taken hostage by the Hamas militants who control the enclave.

With the humanitarian crisis deepening, pressure mounted to immediately provide safety and aid to Gaza’s two million residents. Yet American-led diplomatic efforts have so far yielded few results. Days of efforts to get aid through Egypt’s border with Gaza have failed to bear fruit.

Here is what else to know:

• After visiting Israel on Wednesday, President Biden will not go on to Jordan, a senior administration official said, after the Jordanian government canceled a summit in Amman with regional leaders on the conflict. President Mahmoud Abbas of the Palestinian Authority, who also had been scheduled to attend, had backed out earlier.
• As Secretary of State Antony J. Blinken continues a week of shuttle diplomacy in the Middle East, a senior State Department official said that U.S. and Israeli officials had agreed to develop a plan to get humanitarian aid into Gaza and set up “safe zones.”
• Though Israel has urged Gazan residents to move south away from an Israeli expected ground offensive in the north, Israeli warplanes continued on Tuesday carrying out strikes into southern Gaza near the border with Egypt. At least 72 people were killed and dozens more were wounded in attacks on residential buildings in the cities of Khan Younis and Rafah, Gaza’s Interior Ministry said. The Israeli military said on Tuesday morning that it had struck Hamas targets.
• Hamas said that one of its commanders, Ayman Nofal, was killed in an Israeli strike on a refugee camp in central Gaza. The statement identified him as a commander in the Al-Qassam Brigades, the group’s military wing.