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Fears were growing of a wider Middle East conflict as the United States conducted a new round of airstrikes in eastern Syria against facilities it said were tied to Iran and its proxies and as Israeli forces skirmished with Hezbollah fighters at the border with Lebanon.

But the world’s attention was largely focused on the fighting in Gaza and the spiraling humanitarian crisis there.

At the White House on Monday, President Biden said his administration had conferred with the Israeli government on the issue of hospitals. “The position of the United States on this matter is clear,” he said. “Hospitals should be protected.”

The Israeli military did not address specific questions about its actions around Al-Shifa Hospital. In a statement on Monday, it said that it was “engaged in intense battle against Hamas” and that “this currently includes the area surrounding the Shifa hospital, but not the hospital itself.”

In another statement about the fighting near Al-Quds, the Israeli military said that a “terrorist squad” positioned among civilians at an entrance to the hospital had fired rocket-propelled grenades at Israeli soldiers, damaging an Israeli tank. Israeli forces fired back, the statement said, killing “approximately 21 terrorists.” That account of the fighting could not be immediately verified.

The Red Crescent Society said it “strongly condemns the false claims by the occupying forces about armed individuals launching projectiles from inside Al-Quds Hospital.”

Overall, Gazan health officials, who are part of the Hamas government, say more than 11,000 people have been killed in the Palestinian enclave since the war began, following the Oct. 7 Hamas attacks in Israel that killed an estimated 1,200 people.

Al-Shifa and other medical centers in Gaza City have been struggling for weeks to maintain operations as Israeli forces close in and as supplies of fuel and medicine dwindle. The head of the W.H.O. warned on Sunday that Al-Shifa was “not functioning as a hospital anymore” and was struggling to provide care after three days “without electricity, without water and with very poor internet.”

“The situation here is catastrophic in every sense of the word,” said Jihan Miqdad, a head nurse in the emergency room at Al-Shifa, where medical teams are surviving on biscuits and dates. Patients who were on life support in the intensive care unit were dying because the hospital had so little oxygen, she said.

To care for the premature babies at Al-Shifa, the medical staff is putting sheets of reflective foil and blankets over hospital beds and laying the babies close to one another to replicate as much as possible the warmth of an incubator, said Mr. Abbas, the Gazan health ministry official. Four of the premature babies there were born in emergency C-sections after their mothers were killed in strikes, he said.



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