After an abrupt Israeli pullback at the start of April, Palestinians at both ends of the Gaza Strip were again fleeing for their lives from bombing on Wednesday they described as some of the war's worst.
A spokesperson for Prime Minister Benjamin Netanyahu's government said Israel was "moving ahead" with its plans for a ground operation on Rafah but gave no timeline.
Western countries, including Israel's closest ally the United States, have pleaded with it to hold back from attacking the city on Gaza's southern edge, which is sheltering more than half the enclave's 2.3 million people.
At the White House, US national security adviser Jake Sullivan said Washington was still talking with Israel about Rafah and officials from both countries expected to meet again in person soon.
Palestinians have fled bombings across Gaza they describe as some of the war's worst. (AP PHOTO)
"We've had very detailed discussions ... to talk through not just our concerns, but our view that there is a different way to go about dealing with the Hamas threat in Rafah," he told reporters.
A senior Israeli defence official, speaking on condition of anonymity, said Israel was poised to move civilians before its attack and had bought 40,000 tents that could house 10-12 people each.
All that remained was for Netanyahu to give the order.
At the opposite end of the Gaza Strip in the north, the city of Beit Lahiya came under massive shelling for a second day on Wednesday, a day after the Israeli military ordered residents out of four districts declared a "dangerous combat zone".
Israel said its operations there targeted areas from where the armed wing of Hamas-aligned Islamic Jihad fired rockets at two Israeli border settlements on Tuesday.
Israel has said it will eradicate Hamas following the militants' rampage in southern Israel on October 7 in which 1200 people were killed and 253 were taken hostage, according to Israeli tallies.
Hamas released a video on Wednesday that apparently showed Israeli American hostage Hersh Goldberg-Polin, 23, alive.
Israel has bought thousands of tents for Rafah civilians, a defence official says. (AP PHOTO)
His father, Jonathan Polin, urged leaders to reach a ceasefire deal.
"We're relieved to see him alive but we're also concerned about his health and wellbeing as well as that of all of the other hostages and all of those suffering in this region," his father said in a video message.
The war, now in its seventh month, has killed more than 34,000 Palestinians, according to Gaza health authorities.
The offensive has laid to waste much of the enclave, displacing most of its 2.3 million people and creating a humanitarian crisis.
In the past 24 hours, Israeli strikes had killed at least 79 Palestinians, the Gaza health ministry said.
In the US, protests, some broken up by police, against Israel's campaign in Gaza are spreading on college campuses, as are concerns about Jewish students facing intimidation or anti-Semitism.
Democratic US President Joe Biden, who seeks re-election in November, has seen his stalwart backing of Israel erode support among Democratic voters.
Protests against Israel's campaign in Gaza are spreading on US college campuses. (AP PHOTO)
Asked about the protests, the White House walked a careful line on Wednesday.
Press secretary Karine Jean-Pierre said the president believed free speech and non-discrimination were important on college campuses and students should feel safe.
Residents in the north of Gaza, many of whom have started to return to their homes, on Wednesday described some of the most intense bombing since the war's early weeks.
In Washington, Sullivan said the US had seen a marked increase in aid reaching Gaza and especially vulnerable north Gaza since Biden and Netanyahu spoke on April 4.
Sullivan said the aid flow needed to increase further, a repeated US demand.
The comment came after UN aid agency UNRWA said the number of relief trucks entering the enclave had reached the highest point in the conflict.
