500+ Casualties After Israel Bombs Hospital In Gaza City: Palestinian Officials

Update(1400ET): Horrific reports of a mass casualty bombing are emerging from Gaza, where a hospital suffered direct hit reportedly by Israeli airstrikes. Gaza's health ministry has said there are at least 500 casualties in the aftermath of the hospital blast, with "hundreds of victims" buried under the rubble. Gaza sources also say that a UN-run school housing refugees was attacked.

Initially, local emergency officials said there were at least 200 killed in the mid-evening bombing of al-Ahli Arab Hospital in Gaza City, but the count has been steadily rising. Now, per Al Jazeera: "The health ministry in the Gaza Strip says at least 500 people have been killed in an Israeli attack on al-Ahli Arab Hospital."

Graphic scenes are emerging...

Photographs are circulating of bodies scattered (intentionally blurred) outside of burning hospital wings:

This humanitarian catastrophe is unfolding as President Biden is en route to Israel. Likely many of the victims of the hospital attack were women and children.

Certainly this greatly raises the pressure and the stakes for Biden, as the White House will have to 'answer' for this as Israel's most powerful ally. No doubt the US administration is scrambling to prepare for how it will respond.

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At this point, exchanges of fire between the Israel Defense Forces (IDF) and militants in south Lebanon, especially Hezbollah, have become a daily occurrence - and yet still a full assault from Hezbollah has been avoided. Many analysts have speculated that Israel could be holding off its expected major ground invasion of Gaza precisely to avoid provoking a 'northern front' from opening up.

But there are continuing signs the situation is sliding toward that feared two-front scenario, as the IDF has initiated a plan to evacuate all civilians who live within two kilometers of the Lebanese border. They said the repeat rocket and mortar fire make it necessary, also in preparation for potential greater military action. 

The country's National Emergency Management Authority (NEMA) will oversee transferring of Israeli civilians to state-funded guesthouses. In total a whopping 28 towns and communities will be evacuated.

NEMA has listed them out as follows: Ghajar, Dishon, Kfar Yuval, Margaliot, Metula, Avivim, Dovev, Ma’ayan Baruch, Bar’am, Manara, Yiftah, Malkia, Misgav Am, Yir’on, Dafna, Arab al-Aramshe, Shlomi, Netu’a, Ya’ara, Shtula, Matat, Zar’it, Shomera, Betzet, Adamit, Rosh Hanikra, Hanita and Kfar Giladi.

Many of these in the last several days saw residents flee due to rocket fire from the other side of the border.

Hezbollah has issued new claims it has destroyed an IDF tank and other military assets. Already both sides have taken on a few casualties. 

"Hezbollah carried out a number of attacks yesterday in order to try to divert our operational efforts [away from the Gaza Strip], under the direction and backing of Iran, while endangering the state of Lebanon and its citizens," an IDF spokesman had said Monday.

"We have increased our forces on the northern border and will respond aggressively to any activity against us," the IDF said. "If Hezbollah dares to test us, the reaction will be deadly. The United States is giving us full backing."

Dozens of rockets have been launched from Hezbollah positions in the last days. Israel has in response shelled militant positions in Lebanon, but has also hit Lebanese residential areas, prompting people in the area to flee.

On Tuesday, Hezbollah announced that its fighters launched an anti-tank guided missile (ATGM) at a gathering of Israeli soldiers, which the group said resulted in "a number of casualties".

Meanwhile, Hezbollah's main state backer Iran has continued ratcheting the threats against Israel:

A series of statements from multiple sides point toward continued escalation, which could explode well beyond the Gaza crisis: 

Israel Ministry of Health: "The war may last a long time, prepare an emergency stock of food for 4 months."

Iranian Foreign Minister: "The expansion of the war to other fronts has begun to reach unavoidable stages."

IDF Spokesman: "Israel is prepared on its own both in the north and in the south."

Israeli Military Spokesman: "If Hezbollah commits a grave mistake, we will respond with devastating force never seen before."

Iranian leaders have gone so far as to issue threat of 'preemptive attack' if Israel continues decimating Gaza...

For now, the situation is expected to be contained given President Biden's expected Wednesday trip to Israel. There's widespread belief that Israeli will not go into Gaza with full force so long as the US leader is visiting. 

Additionally, Israel is still facing condemnation and international pressure related to the Reuters crew which was fired upon: "On Friday, Issam Abdallah, a Reuters video journalist, was killed in southern Lebanon after missiles launched from the direction of Israel struck him," writes the New York Times. "Six other journalists — from Reuters, Al Jazeera and Agence France-Presse — were also injured in the attack, which occurred near the village of Alma al-Shaab."