Matthew Miller, a State Department spokesman, said on Monday that while it was too early to make definitive assessments, the United States saw signs that Israel was making changes to limit civilian casualties, including reducing mass displacement.

He pointed to the more detailed evacuation map published by the Israeli military, saying it represented “a much more targeted request” and “an improvement on what’s happened before.”

But the civilian toll has still been heavy. Since the collapse of Israel’s weeklong truce with Hamas on Friday, more than 300 people have been killed each day, according to Gaza’s health officials. Nearly 1.9 million people, or more than 85 percent of all Gazans, have been displaced by the war, according to the United Nations.

Israeli leaders blame Hamas for endangering the civilian population, saying its fighters operate out of underground tunnels and densely populated urban neighborhoods, using men, women and children as human shields.

President Biden on Tuesday blamed the collapse of the cease-fire on Hamas’s refusal to release the women it still holds hostage, referring to “accounts of unimaginable cruelty” by Hamas against women, including rape and mutilation committed during the Oct. 7 assault. He stopped short of suggesting, as a State Department spokesman did on Monday, that Hamas was holding the remaining women because it did not want their experience of abuse to be made public.

Israel does not have an official tally of the number of Hamas fighters killed, according to Colonel Lerner, the military spokesman. But the military estimates it is “several thousands,” he said, based on extrapolations from “information that we’re receiving from the field and from our after-action review.”

Human rights groups have warned that, as the battlefield expands, beleaguered civilians are being pushed into a patchwork of smaller and smaller areas that lack adequate food, shelter and medical care.

With shelters in Rafah already well beyond capacity, new arrivals were erecting tents and fashioning shelters in the streets or whatever empty spaces they can find, according to the United Nations’ office for humanitarian affairs.

“The conditions required to deliver aid to the people of Gaza do not exist,” Lynn Hastings, the U.N. aid coordinator for the Palestinian territories, said in a statement. “If possible, an even more hellish scenario is about to unfold, one in which humanitarian operations may not be able to respond.”

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