By Najib Jobain, Isabel Debre, Ravi Nessman and Matthew Lee

Israel said Wednesday that it will allow Egypt to deliver limited quantities of humanitarian aid to the Gaza Strip, the first crack in a 10-day siege on the territory. Palestinians reeled from a massive blast at a Gaza City hospital that killed hundreds the day before and grew increasingly desperate as food and water supplies ran out.

Prime Minister Benjamin Netanyahu’s office said the decision was approved after a request from visiting U.S. President Joe Biden. It said Israel "will not thwart” deliveries of food, water or medicine, as long as they are limited to civilians in the south of the Gaza Strip and don't go to Hamas militants. The statement made no mention of badly needed fuel.

It was not clear when the aid would start flowing. At Rafah crossing, Gaza’s only connection to Egypt, truckloads of aid have been waiting for days to enter. But the facility has only a limited capacity, and Egypt says it has been damaged by Israeli airstrikes.

Israel's announcement came as rage over Tuesday night's blast at al-Ahli Hospital spread across the Middle East, and just as Biden began his visit to Israel in hopes of preventing a wider conflict in the region. The war started when Hamas militants rampaged across communities in southern Israel on Oct. 7.

There were conflicting claims of who was responsible for the explosion. Hamas officials in Gaza quickly blamed an Israeli airstrike, saying nearly 500 were killed. Israel denied it was involved and released a flurry of video, audio and other information that it said showed the blast was instead due to a rocket misfire by Islamic Jihad, another militant group operating in Gaza. Islamic Jihad dismissed that claim.

The Associated Press has not independently verified any of the claims or evidence released by the parties.

Upon his arrival, Biden embraced Israeli Prime Minister Benjamin Netanyahu — and expressed concern for the suffering of Gaza’s civilians. He later said the hospital blast appeared not to be Israel’s fault.

“Based on what I’ve seen, it appears as though it was done by the other team, not you,” he told Netanyahu in remarks in front of the media.

Palestinian rocket attacks on Israel resumed shortly before Biden’s arrival, after a 12-hour lull. Israeli strikes on Gaza continued Wednesday, including on cities in south Gaza that Israel had described as “safe zones” for Palestinian civilians.

After the hospital blast, Jordan canceled a meeting between Biden, Jordan’s King Abdullah II, Palestinian President Mahmoud Abbas and Egyptian President Abdel Fattah el-Sissi. Biden was now visiting only Israel.

The war between Israel and Hamas was “pushing the region to the brink,” Jordanian Foreign Minister Ayman Safadi told state-run television.

The Israeli military held a briefing Wednesday morning laying out its case for why it was not responsible for the explosion at the al-Ahli Hospital.

Israeli military spokesman Rear Adm. Daniel Hagari said it was not firing in the area when the blast occurred. And, he said, Israeli radar confirmed a rocket barrage was fired by the Palestinian militant group Islamic Jihad from a nearby cemetery at the time of the blast, around 6:59 p.m. Independent video showed one of the rockets in the barrage falling out of the sky, he said.

The misfired rocket hit the parking lot outside the hospital. Were it an airstrike, there would have been a crater there; instead, the fiery blast came from the misfired rocket’s warhead and its unspent propellant, he said.

The Israeli military also released a recording they said was between two Hamas militants discussing the blast, during which the speakers say it was believed to be an Islamic Jihad misfire.

Hagari said Israeli’s intelligence would be shared with U.S. and British officials. He also questioned the death toll provided by Gaza’s Hamas-led Health Ministry.

Since the war began, roughly 450 rockets fired at Israel by militant groups had landed in Gaza, the Israeli military said.

Hamas called Tuesday’s hospital blast “a horrific massacre,” saying it was caused by an Israeli strike. Islamic Jihad dismissed Israel’s claims, accusing Israel of “trying hard to evade responsibility for the brutal massacre it committed.”

The group pointed to Israel’s order that al-Ahli be evacuated and reports of a previous strike at the hospital as proof that the hospital was an Israeli target. It also said the scale of the explosion, the angle of the bomb’s fall and the extent of the destruction all pointed to Israel.

The Anglican bishop of Jerusalem, Hosam Naoum, said the hospital, run by the Episcopal Church, had received at least three Israeli military orders to evacuate in the days before the blast. It was hit by Israeli shelling Sunday, wounding four staffers, he said. Israel had ordered all 22 hospitals in northern Gaza to evacuate last week.

Naoum declined to cast blame on either party for the blast. “As people of the cloth, we are not military experts,” he said. “We just want to let people see what is happening on the ground and hope that people will come to the conclusion that we’ve had enough of this war.”

The blast left gruesome scenes. Hundreds of Palestinians had taken refuge in al-Ahli and other hospitals in Gaza City, hoping they would be spared bombardment after Israel ordered all residents of the city and surrounding areas to evacuate to the southern Gaza Strip.

On Wednesday morning, the blast scene was littered with charred cars and the ground was blackened by debris. One man who had been sheltering there with his family, Mohammed al-Hayek, said he was sitting with other men in a hospital stairwell Tuesday night, idling away the hours but wary of sitting in the yard.

He stepped away to get them coffee when the blast hit.

“When I returned, they were torn to pieces,” he said. Struggling to speak, he pointed to where their bodies had lain. The stone walls were still splattered with blood. “No one knows anyone,” he managed to say, referring to the difficulty in identifying the victims.

Video after the blast showed the hospital grounds strewn with torn bodies, many of them young children.

Some 350 casualties from the al-Ahli blast were rushed to Gaza City’s main hospital, al-Shifa, which was already overwhelmed with wounded from other strikes, said its director, Mohammed Abu Selmia. He said doctors were performing surgery – often without anesthesia – on patients lying on floors.

“We need equipment, we need medicine, we need beds, we need anesthesia, we need everything,” Abu Selmia said. He warned that fuel for the hospital’s generators would run out within hours.

The death toll was in dispute, even among those in Gaza. The Health Ministry initially said 500 had died, but revised that number to 471 on Wednesday, without giving details of the dead. Al-Ahli officials said only that the toll was in the hundreds. Abu Selmia said he thought the toll was closer to 250.

The Gaza Health Ministry said 3,478 people have been killed in Gaza and more than 12,000 wounded, with most of the casualties women, children and the elderly. Another 1,300 people across Gaza are believed to be buried under the rubble, alive or dead, health authorities said.

More than 1,400 people in Israel have been killed, mostly civilians slain during Hamas’ deadly incursion, which resulted in some 200 hostages taken into Gaza. Militants in Gaza have launched rockets every day since toward cities across Israel.

With troops massed along the border, Israel has been expected to launch a ground invasion into Gaza, though military officials say no decision has been made.

A strike on a three-story building in Gaza City on Wednesday killed 40 people and another on a bakery in the Nuseirat refugee camp in central Gaza killed four bakers, according to witnesses.

The Israeli military says it is targeting Hamas hideouts, infrastructure and command centers and accuses the militants of hiding among civilians.

“It’s not just that people are going hungry. People are at the risk of starvation,” Alia Zaki, a spokesperson for the World Food Program, said.

More than 1 million Palestinians have fled their homes — roughly half of Gaza’s population — and 60% are now in the approximately 14-kilometer (8-mile) long area south of the evacuation zone, the U.N. said.

Debre and Nessman reported from Jerusalem. Associated Press journalists Amy Teibel in Jerusalem; Samya Kullab in Baghdad; Abby Sewell in Beirut; Samy Magdy and Jack Jeffrey in Cairo; and Ashraf Sweilam in el-Arish, Egypt, contributed to this report.

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