Crowds of Palestinian families stretching as far as the eye could see walked out of Gaza City and surrounding areas toward the south late on Thursday to escape Israeli airstrikes and ground troops battling Hamas militants in dense urban neighbourhoods.

Others joined tens of thousands taking shelter at the city’s biggest hospital, not far from the fighting.

Gaza’s largest city is the focus of Israel’s campaign to crush Hamas following its deadly October 7 incursion — and the Israeli military says Hamas’ main command centre is located in and under the Shifa Hospital complex.

The militant group and hospital staff deny that claim, saying the military is creating a pretext to strike it.

Growing numbers of people have been living in and around the hospital complex, hoping it will be safer than their homes or United Nations shelters in the north, several of which have been hit repeatedly.

Israeli troops were around two miles from the hospital, according to its director.

The accelerating exodus to the south came as Israel agreed to a four-hour humanitarian pause each day and to open a second route for people to flee the north, the White House said.

Asked about the agreement in a Fox News interview that aired on Thursday, Israeli Prime Minister Benjamin Netanyahu replied that “the fighting continues against the Hamas enemy, the Hamas terrorists, but in specific locations for a given period, a few hours here, a few hours there, we want to facilitate a safe passage of civilians away from the zone of fighting. And we’re doing that.”

Meanwhile, Western and Arab officials gathered on Thursday in Paris to discuss ways of providing more aid to civilians in Gaza.

Separately, mediators worked on a possible deal for a three-day cease-fire in exchange for the release of around a dozen hostages held by Hamas, according to two Egyptian officials, a United Nations official and a Western diplomat.