The health ministry in the Gaza Strip says hundreds of victims are trapped under the rubble of the Ahli Arab Hospital after up to 500 people were killed in Israeli airstrikes on Tuesday.
US President Joe Biden landed just before 11 a.m. local (4 a.m. eastern) in Israel on Wednesday to signal Washington's support, his second visit to a war zone this year.
Biden, who has expressed "iron-clad" support for Israel in its war on Gaza, was welcomed on the tarmac by hardline prime minister Benjamin Netanyahu.
The visit followed head of US Central Command Gen. Erik Kurilla's arrival in Tel Aviv for meetings with Israeli military authorities a day earlier.
Israel's military campaign had already left at least 3,000 dead inside Gaza before the hospital was destroyed.
The horror of the hospital deaths threatened to derail his high-stakes visit, with Jordan cancelling a summit where King Abdullah II had been due to host Biden, Palestinian president Mahmud Abbas and Egyptian President Abdel Fattah al-Sisi.
Thousands of civilians were seeking medical treatment and shelter in the hospital from relentless Israeli airstrikes when the attack took place.
The attack is the deadliest Israeli airstrike since 2008, the Palestinian Civil Defense said.
“The massacre at the Ahli Arab Hospital is unprecedented in our history. While we’ve witnessed tragedies in past wars and days, but what took place tonight is tantamount to genocide,” spokesman Mahmoud Basal said.
The media office of Hamas described the attack as a "war crime."
"The hospital was housing hundreds of sick and wounded, and people forcibly displaced from their homes" because of other strikes, a statement said.
The Palestine Red Crescent Society (PRCS) condemned the Israeli attack as genocide.
Palestinian Authority (PA) President Mahmoud Abbas declared three days of mourning following the Israeli air strike.
Photos from the Ahli Arab Hospital showed fire engulfing the hospital halls, shattered glass and body parts scattered across the area.
Biden has strongly backed top ally Israel and its military campaign after 1,400 people were killed in Israel in a surprise operation launched by Hamas on October 7.
Entire Gaza neighborhoods have been razed and survivors are left with dwindling supplies of food, water and fuel, unable to flee the 40-kilometer long strip that has been blockaded since 2007 by Israel and Egypt.
The situation in the Gaza Strip is spiraling out of control, head of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus warned on Wednesday.
"Every second we wait to get medical aid in, we lose lives," he said. "We need immediate access to start delivering life-saving supplies."
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