Palestinians sheltering in tents or seeking the scarce food aid available in the Strip were among at least 33 people killed by Israeli attacks and gunfire in Gaza on Saturday, according to local hospitals, as the world grappled with a rare announcement about the famine in the besieged enclave's largest city.

Israel's defense minister has warned that Gaza City could be destroyed in a new military operation that could begin within days, even as famine spreads in the enclave.

Aid groups have long warned that the conflict, following the Hamas attack on October 7, 2023, and Israeli restrictions on the entry of food and medical supplies into the territory are causing hunger among civilians.

Israel has dismissed the famine declaration as a lie, and its army is moving forward with preparations to take Gaza City. Efforts to achieve a ceasefire are on hold while mediators await Israel's next steps.

Israeli strikes caused at least 17 deaths in the southern Gaza Strip, more than half of them women and children, according to morgue records and officials at Nasser Hospital. Health officials said the attacks targeted tents housing displaced people in Yan Yunis.

“Awad, why did you leave me?” a little boy asked his brother’s plastic-wrapped body.

A grieving relative, Hekmat Foujo, called for a ceasefire.

“We want to rest,” Foujo said, fighting back tears. “Have mercy on us.”

In northern Gaza, Israeli gunfire killed at least five people seeking aid Saturday near the Zikim border crossing, where U.N. and other agencies' convoys enter the enclave, health officials at the Sheikh Radwan field hospital told the AP.

The Palestinian Journalists Syndicate said cameraman Khaled al-Madhoun was killed while covering events at the Zikim crossing, claiming he was attacked by Israeli troops. Local Palestine TV confirmed his death.

Eleven people were killed in other attacks in Gaza on Saturday, according to hospitals and the Palestinian Red Crescent.

The Israeli military said it was not aware of an attack in Yan Yunis at that location and was investigating the other incidents.

AP journalists have seen chaos on the access roads to the distribution centers, and almost daily reports of Israeli troops shooting at those seeking aid have emerged. The army maintains it only fires warning shots if people approach its troops or pose a threat.

Mohamed Saada was among the thousands of people searching for food in the Zikim area, and he was one of the many who left empty-handed. He mentioned the “large number of people,” gunfire, and “trucks running over people.”

Some carried sacks of food like lentils and flour. Others carried the wounded, even on a wooden pallet. They navigated through fetid puddles and the rubble of war as temperatures soared above 33 degrees Celsius (92 degrees Fahrenheit).

The Integrated Food Security Phase Classification (IPC) famine report released Friday indicates that nearly half a million people, roughly a quarter of Gaza's population, face catastrophic hunger.

The unusual statement came after Israel imposed a two-and-a-half-month blockade on Gaza earlier this year, only to later facilitate access through a new, US-backed private distributor of aid known as the Gaza Humanitarian Foundation (GHF).

In response to global outrage over images of malnourished children, Israel has allowed airdrops and more supplies to enter Gaza in recent weeks, but the UN and other aid agencies say the food reaching Gaza is still not enough.

Netanyahu's office claims it has allowed sufficient aid to enter the country during the conflict, while accusing Hamas of starving the hostages it holds.

With ground troops already deployed on the outskirts of Gaza City, a large-scale operation could begin within days in an area with hundreds of thousands of civilians. According to Israel, Gaza City remains a Hamas stronghold, with a vast network of tunnels.

The aid group Doctors Without Borders, or MSF, said its clinics around the city have seen an increase in the number of patients as people flee. Caroline Willemen, MSF project coordinator, noted a marked increase in airstrikes since early August.

“Those who haven't been displaced are wondering what they should do,” he told the AP. “People want to stay; they've been displaced relentlessly before, but they also know that at some point it will be very dangerous to stay.”

Many Israelis fear that the assault on Gaza City could doom the approximately 20 hostages who have survived captivity since 2023. Another 30 are believed to be dead. Hundreds of thousands of Israelis protested a week ago for an agreement to end the fighting and bring everyone home.

“Anyone who truly wants to bring the hostages home doesn’t launch a ground invasion of Gaza,” said Yotam Cohen, brother of hostage Nimrod Cohen, before a weekly demonstration in Tel Aviv.

Netanyahu said Thursday he had ordered officials to begin immediate negotiations to free the hostages and end the war on Israel's terms. It is unclear whether Tel Aviv will return to the talks mediated by the United States, Egypt, and Qatar after Hamas said earlier this week it had accepted a new proposal from Arab mediators.

Hamas said it would release the hostages in exchange for an end to the war, but rejects disarmament without the creation of a Palestinian state.

US President Donald Trump expressed frustration with Hamas's stance and suggested the group was less interested in making deals to free the hostages with so few of them still alive.

“I actually think (the hostages are) safer in many ways if you go in and really go in fast and do it,” Trump told reporters on Friday.

The Gaza Health Ministry said at least 62,622 Palestinians have died in the war, including missing persons whose deaths have been confirmed by a special judicial committee within the ministry.

The number of malnutrition-related deaths rose by eight to 281, the ministry said.

A small group of Israelis protested against far-right National Security Minister Itamar Ben-Gvir as he walked toward a synagogue in Kfar Malal, north of Tel Aviv. In videos, the minister is seen arguing with protesters.

"We don't want them in our town. Our message is to bring back the hostages," one of the protesters, Boaz Levinstein, told the AP.

Ben-Gvir is a key partner in Netanyahu's political coalition and a staunch opponent of reaching an agreement with Hamas, which, for the hostages' families, is the only way to secure the release of their loved ones.