Thirty-one premature babies were evacuated from Gaza's biggest hospital Sunday, the World Health Organization said, seeking to get the last patients and staff out of what it has dubbed a "death zone".
The evacuation came as Israel, which said it was stepping up military operations against Hamas militants, announced it had found a 55-metre tunnel under the Al-Shifa hospital and released footage it said showed "hostages" inside the facility.
The developments, as sirens blared across Jerusalem to warn of rocket fire while Israel intensified air strikes on Gaza City, came as Qatar said "minor" obstacles remained for a deal on the release of hostages.
Civilians scurried for cover in Jerusalem as loud blasts from intercepted missiles pierced the air and in the evening an AFP reporter in Gaza heard warplanes strike repeatedly the centre of Gaza City.
Al-Shifa hospital has become the focus of the war that began 7 October when Gaza-based Hamas militants stormed across the militarised border to kill, according to Israeli officials, around 1,200 people and take roughly 240 hostages.
The Hamas government says the death toll from Israel's relentless aerial bombardment and ground operations in Gaza, has reached 13,000.
Most of the casualties on both sides are civilians, while the army has reported 64 troops deaths in Gaza so far.
WHO chief Tedros Adhanom Ghebreyesus said 31 "very sick" babies were moved in a joint operation with the UN and the Palestinian Red Crescent Society.
"They are receiving urgent care in the neonatal intensive care unit" of the Al-Helal Emirati field hospital in Rafah, across the border from Egypt, he wrote on X, formerly Twitter.
An AFP photographer saw the tiny infants at the hospital, some three or four to a cot, being bottle-fed by nurses and tended to by doctors.
Israel has said its military was "expanding its operational activities in additional neighbourhoods... of the Gaza Strip" where the United Nations says about 1.6 million people have been internally displaced by weeks of fighting.
The coastal territory, under a crippling blockade since Hamas took power in 2007, has been besieged by Israel since the war erupted, leaving food, water, medicine and fuel in short supply.
And more than half of Gaza's 36 hospitals are non-functioning by shortages, combat or damage, the UN says.
On Saturday, hundreds fled Al-Shifa hospital on foot as loud explosions were heard around the complex. Columns of sick and injured were seen leaving with displaced people, doctors and nurses.
At least 15 bodies, some in advanced stages of decomposition, were strewn along the route, an AFP journalist said.
The WHO said 29 patients at the hospital with serious spinal injuries cannot move without medical assistance.
Israel has told Palestinians to move south for their safety, but deadly strikes continued there too.
On Sunday 41 members of one family were killed in an Israeli bombardment of their home in Gaza's Zeytoun district, the Hamas-run health ministry said.
Israeli troops raided Al-Shifa Hospital Wednesday on suspicion that it was being used as a Hamas base.
On Sunday the army said "troops exposed a 55-meter-long terror tunnel 10 metres deep underneath the Shifa hospital complex," which ran under the hospital and ended at a blast door.
Later the military released CCTV footage, which appears to be time-stamped 7 October, that it said showed two male hostages from Nepal and Thailand being brought into Al-Shifa.
"We have not yet located both of these hostages," army spokesman Daniel Hagari told reporters. AFP could not immediately verify the footage.
Israel has been under pressure to prove its claims that a Hamas command centre is concealed beneath the hospital, a charge the militants and medical staff have denied.
Conditions at Al-Shifa are dire, according to the WHO, with a mass grave outside and nearly 300 patients and 25 health workers inside.
It urged an immediate ceasefire given the "extreme suffering of the people of Gaza".
Al-Shifa head of surgery Marwan Abu Sada told AFP that Israeli troops were still in the hospital and it was surrounded by tanks.
"I heard at least two explosions since this morning," he said.
Other doctors said the troops were going from building to building and detonated explosives on the ground floors and hospital basements searching for Hamas tunnels.
A Hamas health official said more than 80 people were killed on Saturday in twin strikes on Jabalia refugee camp, the territory's largest, including on a UN school sheltering displaced people.
The Israeli army said only that "an incident in the Jabalia region" was under review without elaborating.
"The horrendous events of the past 48 hours in Gaza beggar belief," United Nations High Commissioner for Human Rights Volker Turk said in a statement.
With just a trickle of aid allowed in from Egypt, Israel permitted a first consignment of fuel to enter Gaza late Friday under US pressure, allowing telecommunications to resume after a two-day blackout.
Some 120,000 litres (31,700 gallons) of fuel arrived on Saturday, the UN said.
A US official has said more fuel deliveries and a "significant pause" in fighting would come "when hostages are released".
Qatar's Prime Minister Mohammed bin Abdulrahman Al Thani said on Sunday a deal to free hostages hinges on "very minor" practical issues, without elaborating.
US deputy national security adviser Jon Finer told NBC they were "closer than we have been in quite some time" to securing a deal. But he added on CBS: "The mantra that nothing is agreed until everything is agreed really does apply."
The bodies of two female captives were recovered in Gaza this week, the Israeli military said, while four abductees have so far been released by Hamas and a fifth rescued by troops.
France said it was sending a navy helicopter carrier to provide medical assistance in Gaza and on Sunday President Emmanuel Macron told Israeli prime minister Benjamin Netanyahu there were "too many civilian losses" in Israel's war against Hamas in Gaza,
US president Joe Biden threatened sanctions against Israeli settlers who have ramped up attacks on Palestinians in the West Bank, where settlers and troops have killed more than 200 Palestinians in recent weeks, according to the health ministry in Ramallah.
Also Sunday, the Iran-backed Huthi rebels claimed they had seized an Israeli ship in the vital waters of the Red Sea, but Israel denied the allegation and said the vessel was operated by a Japanese company.
In Iran, supreme leader Ayatollah Ali Khamenei said Israel suffered a "defeat" in its war against Hamas.