GAZA CITY, Gaza Strip — Israel has approved a cease-fire plan to halt an 11-day military operation in the Gaza Strip, according to multiple reports. President Joe Biden is expected to make remarks about the agreement at 5:45 p.m. ET.

The Associated Press reports Israeli Prime Minister Benjamin Netnayaho’s office announced the cease-fire Thursday, saying his security cabinet unilaterally approved a proposal mediated by Egypt.

A Hamas official told Reuters that the ceasefire would be “mutual and simultaneous,” though the organization has not yet publicly commented on the reported cease-fire.

A statement from Netnayaho’s office said the sides are still determining when the truce will take effect. But local outlets have reported it would go into effect at 2 a.m. local time.

The cease-fire decision came amid global pressure on both Israel and Hamas to quell the violence that has erupted in Gaza in the past week.

Reports indicated earlier on Thursday that the two sides could agree to a ceasefire soon. According to reports from CNN and the Wall Street Journal, a cease-fire in Gaza was "imminent" and could occur as soon as this week.

At a press briefing on Thursday, White House press secretary Jen Psaki called the reports "encouraging" and added that the administration is continuing to implement its policy in the region "quietly and through diplomatic channels."

The Wall Street Journal reported Wednesday that Egyptian officials have made headway in negotiations with Hamas leadership. That report came hours after President Joe Biden, in a call Wednesday with Israeli Prime Minister Benjamin Netanyahu, called for "significant de-escalation" in the region and urged him to find a "path to a cease-fire."

Following that call, Netanyahu released a statement saying that he remains committed to the military operation. However, Biden administration officials told the Wall Street Journal on Wednesday that they believe "a cease-fire could come this week, barring any unforeseen clashes that might topple the fragile discussions."

During Thursday's briefing, Psaki declined to disclose if Israel had met Biden's calls for "significant de-escalation."

"We're not going to give a day-by-day grade here," she said adding that Hamas and Israel are "to a point where they should be in a position to end this conflict."

Prior to Wednesday's call, the Biden White House had primarily avoided directly appealing to Israel to reduce violence. Earlier this week, White House press secretary Jen Psaki maintained that while the U.S. is committed to de-escalating violence in the region, she added that the Biden administration believed that Israel had a right to defend itself.

According to CNN, more than 220 Palestinians, including more than 60 children, had been killed in the 10 days of violence. CNN added that during that time span, 12 Israelis had been killed, including two children.

While Hamas, a Palestinian fundamentalist military operation, has fired hundreds of rockets into Israel, Israeli defense systems have shot down the majority of those missiles.

GAZA STRIP —

Related video above: Middle East on the brink?

Just weeks ago, the Gaza Strip's feeble health system was struggling with a runaway surge of coronavirus cases. Authorities cleared out hospital operating rooms, suspended nonessential care and redeployed doctors to patients having difficulty breathing.

Then, the bombs began to fall.

This week's violence between Israel and Gaza's Hamas rulers has killed 103 Palestinians, including 27 children, and wounded 530 people in the impoverished territory. Israeli airstrikes have pounded apartments, blown up cars and toppled buildings.

Doctors across the crowded coastal enclave are now reallocating intensive care unit beds and scrambling to keep up with a very different health crisis: treating blast and shrapnel wounds, bandaging cuts and performing amputations.

Distraught relatives didn't wait for ambulances, rushing the wounded by car or on foot to Shifa Hospital, the territory's largest. Exhausted doctors hurried from patient to patient, frantically bandaging shrapnel wounds to stop the bleeding. Others gathered at the hospital morgue, waiting with stretchers to remove the bodies for burial.

At the Indonesia Hospital in the northern town of Jabaliya, the clinic overflowed after bombs fell nearby. Blood was everywhere, with victims lying on the floors of hallways. Relatives crowded the ER, crying out for loved ones and cursing Israel.

"Before the military attacks, we had major shortages and could barely manage with the second (virus) wave," said Gaza Health Ministry official Abdelatif al-Hajj by phone as bombs thundered in the background. "Now casualties are coming from all directions, really critical casualties. I fear a total collapse."

Gutted by years of conflict, the impoverished health care system in the territory of more than 2 million people has always been vulnerable. Bitter division between Hamas and the West Bank-based Palestinian Authority and a nearly 14-year blockade imposed by Israel with Egypt's help also has strangled the infrastructure. There are shortages of equipment and supplies such as blood bags, surgical lamps, anesthesia and antibiotics. Personal protection gear, breathing machines and oxygen tanks remain even scarcer.

Last month, Gaza's daily coronavirus cases and deaths hit record highs, fueled by the spread of a variant that first appeared in Britain, relaxation of movement restrictions during Ramadan, and deepening public apathy and intransigence.

In the bomb-scarred territory where the unemployment rate is 50%, the need for personal survival often trumps the pleas of public health experts. While virus testing remains limited, the outbreak has infected more than 105,700 people, according to health authorities, and killed 976.

As cases climbed last year, stirring fears of a health care catastrophe, authorities set aside clinics just for COVID-19 patients. But that changed as airstrikes pummeled the territory.

Nurses at the European Hospital in the town of Khan Younis, frantically needing room for the wounded, moved dozens of virus patients in the middle of the night to a different building, said hospital director Yousef al-Akkad. Its surgeons and specialists, who had deployed elsewhere for the virus, rushed back to treat head injuries, fractures and abdominal wounds.

If the conflict intensifies, the hospital won't be able to care for the virus patients, al-Akkad said.

"We have only 15 intensive care beds, and all I can do is pray," he said, adding that because the hospital lacks surgical supplies and expertise, he's already arranged to send one child to Egypt for reconstructive shoulder surgery. "I pray these airstrikes will stop soon."

At Shifa, authorities also moved the wounded into its 30 beds that had been set aside for virus patients. Thursday night was the quietest this week for the ICU, as bombs had largely fallen elsewhere in Gaza. Patients with broken bones and other wounds lay amid the din of beeping monitors, intercoms and occasional shouts by doctors. A few relatives huddled around them, recounting the chaotic barrage.

"About 12 people down in one airstrike. It was 6 p.m. in the street. Some were killed, including my two cousins and young sister. It's like this every day," said 22-year-old Atallah al-Masri, sitting beside his wounded brother, Ghassan.

Hospital director Mohammed Abu Selmia lamented the latest series of blows to Gaza's health system.

"The Gaza Strip is under siege for 14 years, and the health sector is exhausted. Then comes the coronavirus pandemic," he said, adding that most of the equipment is as old as the blockade and can't be sent out for repairs.

Now, his teams already strained by virus cases are treating bombing victims, more than half of whom are critical cases needing surgery.

"They work relentlessly," he added

To make matters worse, Israeli airstrikes hit two health clinics north of Gaza City on Tuesday. The strikes wreaked havoc on Hala al-Shawa Health Center, forcing employees to evacuate, and damaged the Indonesian Hospital, according to the World Health Organization. Israel, already under pressure from an International Criminal court investigation into possible war crimes during the 2014 war, reiterated this week that it warns people living in targeted areas to flee. The airstrikes nonetheless have killed civilians and inflicted damage on Gaza's infrastructure.

The violence also has closed a few dozen health centers conducting coronavirus tests, said Sacha Bootsma, director of WHO's Gaza office. This week, authorities conducted some 300 tests a day, compared with 3,000 before the fighting began.

The U.N. Relief and Works Agency, or UNRWA, ordered staff to stay home from its 22 clinics for their safety. Those now-closed centers had also administered coronavirus vaccines, a precious resource in a place that waited months to receive a limited shipment from the U.N.-backed COVAX program. Those doses will expire in just a few weeks and get thrown away, with "huge implications for authorities' ability to mobilize additional vaccines in the future," Bootsma said.

For the newly wounded, however, the virus remains an afterthought.

The last thing that Mohammad Nassar remembers before an airstrike hit was walking home with a friend on a street. When he came to, he said, "we found ourselves lying on the ground."

Now the 31-year-old is hooked up to a tangle of tubes and monitors in the Shifa Hospital surgical ward, with a broken right arm and a shrapnel wound in his stomach.

GAZA CITY, Gaza Strip —

Turmoil from the battle between Israel and Hamas spilled over into the West Bank on Friday, sparking the most widespread Palestinian protests in years as hundreds of young demonstrators in multiple towns clashed with Israeli troops, who shot and killed at least 11 people.

Video above: Palestinians in Gaza seek shelter in UN schools

Israel's bombardment of the Gaza Strip continued into early Saturday, when an airstrike on a house in Gaza City killed at least seven Palestinians — the highest number of fatalities in a single hit. That strike came a day after a furious overnight barrage of tank fire and airstrikes that wreaked destruction in some towns, killed a family of six in their house and sent thousands fleeing their homes.

The Israeli military said the operation involved 160 warplanes dropping some 80 tons of explosives over the course of 40 minutes and succeeded in destroying a network of tunnels used by Hamas to elude airstrikes and surveillance.

Israel appeared determined to inflict as much damage as possible on Gaza's Hamas rulers before international efforts for a cease-fire accelerated. Since Monday night, Hamas has fired hundreds of rockets into Israel, which has pounded the Gaza Strip with strikes. In Gaza, at least 126 people have been killed, including 31 children and 20 women; in Israel, seven people have been killed, including a 6-year-old boy and a soldier.

Houda Ouda said she and her extended family ran frantically into their home in the Gaza town of Beit Hanoun, seeking safety as the earth shook in the darkness.

"We even did not dare to look from the window to know what is being hit," she said. When daylight came, she saw the destruction: streets cratered, buildings crushed or with facades blown off, an olive tree burned bare, dust covering everything.

The latest airstrike targeted a three-story house on the edge of a refugee camp. Said Alghoul, who lives nearby, said Israeli warplanes dropped at least three bombs on the home without warning residents in advance.

"I could not endure and ran back to my home," he said. Rescuers called a bulldozer to dig through the rubble for survivors or bodies.

Shortly afterward, Hamas said it fired a salvo of rockets at southern Israel in response to the airstrike.

The conflict, which was sparked by tensions in Jerusalem during the past month, has reverberated widely. Israeli cities with mixed Arab and Jewish populations have seen daily violence, with mobs from each community clashing and trashing each other's property. New clashes broke out Friday in the coastal city of Acre.

In the occupied West Bank, on the outskirts of Ramallah, Nablus and other towns and cities, hundreds of Palestinians protested against the Gaza campaign and Israeli actions in Jerusalem. Waving Palestinian flags, they trucked in tires that they set up in burning barricades and hurled stones at Israeli soldiers. At least 10 protesters were shot and killed by soldiers. An 11th Palestinian was killed when he tried to stab a soldier at a military position.

In east Jerusalem, online video showed young Jewish nationalists firing pistols as they traded volleys of stone with Palestinians in Sheikh Jarrah, which became a flashpoint for tensions over attempts by settlers to forcibly evict a number of Palestinian families from their homes.

On Israel's northern border, troops opened fire when a group of Lebanese and Palestinian protesters on the other side cut through the border fence and briefly crossed. One Lebanese was killed. Three rockets were fired toward Israel from neighboring Syria, but they either landed in Syrian territory or in empty areas, Israeli media said. It was not immediately known who fired them.

The spiraling violence has raised fears of a new Palestinian "intifada," or uprising, at a time when the peace process has been virtually nonexistent for years. The tensions began in east Jerusalem earlier this month, with Palestinian protests against the Sheikh Jarrah evictions and Israeli police measures at Al-Aqsa Mosque, a frequent flashpoint located on a mount in the Old City revered by Muslims and Jews.

Hamas fired rockets toward Jerusalem late Monday, in an apparent attempt to present itself as the champion of the protesters. In the conflict that spiraled from there, Israel says it wants to inflict as much damage as it can on Hamas' military infrastructure in Gaza.

Prime Minister Benjamin Netanyahu vowed that Hamas would "pay a very heavy price" for its rocket attacks. Israel called up 9,000 reservists Thursday to join its troops massed at the Gaza border.

An Egyptian intelligence official said Israel had turned down an Egyptian proposal for a one-year cease-fire that Hamas had accepted. The official, who was close to Egypt's talks with both sides, spoke on condition of anonymity to discuss the internal negotiations.

On Friday, the U.S. deputy assistant secretary of state for Israel-Palestinian affairs, Hady Amr, arrived in Israel as part of an attempt by Washington to de-escalate the conflict.

U.S. President Joe Biden gave a show of support to Netanyahu in a call a day earlier, saying "there has not been a significant overreaction" in Israel's response to Hamas rockets. He said the aim is to get a "significant reduction in attacks, particularly rocket attacks."

Hamas has fired some 2,000 rockets toward Israel since Monday, according to the Israeli military. Most have been intercepted by anti-missile defenses, but they have brought life to a standstill in southern Israeli cities, caused disruptions at airports and have set off air raid sirens in Tel Aviv and Jerusalem.

Rafat Tanani, his pregnant wife and four children, ages 7 and under, were killed after an Israeli warplane reduced their four-story apartment building to rubble in the neighboring town of Beit Lahia, residents said. Four strikes hit the building, Rafat's brother Fadi said. The building's owner and his wife also were killed.

"It was a massacre," said Sadallah Tanani, another relative. "My feelings are indescribable."

When the sun rose Friday, residents streamed out of the area in pickup trucks, on donkeys and on foot, taking pillows, blankets, pots and pans and bread. Thousands took shelter inside 16 schools run by the United Nations relief agency UNWRA, agency spokesman Adnan Abu Hasna said.

Mohammed Ghabayen, who took refuge in a school with his family, said his children had eaten nothing since the day before, and they had no mattresses to sleep on. "And this is in the shadow of the coronavirus crisis," he said. "We don't know whether to take precautions for the coronavirus or the rockets or what to do exactly."

Israeli military officials cheered the operation as a successful blow against the tunnel network. Lt. Col. Jonathan Conricus, a military spokesman, said 160 warplanes operated in a "synchronized manner" for about 40 minutes as part of the operation.

He said the military aims to minimize collateral damage in striking military targets. But measures the military takes in other strikes, such as warning shots to get civilians to leave, were not "feasible this time."

Military correspondents in Israeli media said the military believed dozens of militants were killed inside the tunnels. The Hamas and Islamic Jihad militant groups have confirmed 20 deaths in their ranks, but the Israeli military said the real number is far higher.

"We turned the tunnels which they thought were death traps for our soldiers into traps for them." Reserve Air Force Col. Koby Regev said on Israeli television.

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Keath reported from Cairo. Associated Press writers Isabel DeBre in Dubai, United Arab Emirates, and Samy Magdy in Cairo also contributed to this report.