Israel will begin daily four-hour pauses in northern Gaza to allow people to flee hostilities, the White House said on Thursday.

White House national security spokesperson John Kirby said the pauses emerged out of discussions between U.S and Israeli officials in recent days, including talks U.S. President Joe Biden had with Israeli Prime Minister Benjamin Netanyahu.

Kirby said the pauses would allow people to get out of harm's way and for deliveries of humanitarian aid, and could be used as a way to get hostages out.

"We think these are significant first steps here and obviously we want to see them continued for as long as they are needed," said Kirby.

Biden also told reporters in Washington before departing on a visit to an Illinois auto plant that he had asked the Israelis for a "pause longer than three days" during negotiations over the release of some hostages held by Hamas, though he ruled out the chances of a general ceasefire.

Confirmation from Israeli officials of the pauses was not immediately available.

Israel unleashed its assault on Gaza in response to a cross-border Hamas raid on southern Israel on Oct. 7 in which gunmen killed 1,400 people, mostly civilians including several Canadians.

About 240 hostages were captured, according to Israeli tallies. 

Warring sides dispute military death toll

Israeli forces fought Hamas militants among ruined buildings in the north of the Gaza Strip on Thursday, inching their way closer to two big hospitals as the plight of civilians in the besieged Palestinian territory worsened.

Thousands more Palestinians were fleeing from the embattled north to the south along a perilous frontline path after Israel told them to evacuate, residents say.

But many are staying in the north, packed into the Al Shifa Hospital and al-Quds Hospital as ground battles rage around them and Israeli airstrikes rain down from above.

Israel says its Hamas foes have command centres embedded in the hospitals.

Israel says 33 of its soldiers have been killed in its ground operation. The armed wing of Hamas said it had killed a greater number of Israeli soldiers than that, and also destroyed dozens of tanks, bulldozers, and other vehicles.

WHO concerned about disease spread

At least 10,812 Palestinians, including 4,412 children, have been killed in Israeli strikes on Gaza since Oct. 7, the health ministry in Hamas-controlled Gaza said on Thursday.

Thousands of Palestinians have sought refuge at Al Shifa hospital inside Gaza City despite Israel's orders to evacuate the area it has encircled. They are sheltering in tents in the hospital grounds and say they have nowhere else to go.

Huge numbers of displaced people from among Gaza's 2.3 million population are already crammed into schools, hospitals and other sites in the south. Thousands of others remain in the north, including at Gaza City's main Al Shifa hospital.

Although the fighting is concentrated in the north, southern areas have also come under regular assault. In Khan Younis, Gaza's main southern city, residents picked through the rubble and twisted debris of a building destroyed by an Israeli air strike, hoping to find survivors, on Thursday morning, witnesses said.

"As deaths and injuries in Gaza continue to rise due to intensified hostilities, intense overcrowding and disrupted health, water, and sanitation systems pose an added danger: the rapid spread of infectious diseases," the World Health Organization said.

A key crossing between the Gaza Strip and Egypt remained closed well into Thursday to thousands looking to leave the enclave, including hundreds of Canadian citizens. Evacuations for foreign passport holders and Palestinians needing medical treatment later resumed through the Rafah crossing, Egyptian security and medical sources said.

Global Affairs Canada says Canadian officials in Egypt remain ready to welcome those leaving the territory and help them get to Cairo. Those coming from Gaza are allowed to stay in Egypt for up to three days.