The fragile truce had mostly held until now, but this new wave of attacks suggests plans for a permanent end to the war may be off the table.

The airstrikes on Tuesday shattered the relative peace that Gazans had been experiencing since January, and hospitals are once again overrun with casualties.

“The attacks were so sudden that the number of medical staff available was inadequate for the scale of these large strikes, and additional teams were called in immediately to assist,” Mohammed Zaquot, director general of the Gaza Strip’s hospitals, told BBC Arabic.

In his address, Netanyahu said Israel had tried to negotiate with Hamas to release the Israeli hostages still being held in Gaza. He accused Hamas of rejecting the proposals every time.

Israel and Hamas have disagreed on how to take the ceasefire deal forward since the first phase expired in early March, after numerous exchanges of Israeli hostages and Palestinian prisoners.

The deal involves three stages, and negotiations on the second stage were meant to have started six weeks ago – but this did not happen.

Instead, the agreement was thrown into uncertainty when the US and Israel wanted to change the terms of the deal, to extend stage one which would see more hostages released.

That would have delayed the start of phase two, which was meant to establish a permanent ceasefire and required Israeli troops to pull out of Gaza.

But Hamas rejected this proposed change to the agreement brokered by US, Qatari and Egyptian mediators, calling it unacceptable.

On Tuesday evening, Netanyahu said Israel would continue to fight to achieve all of its war goals – “to return the hostages, get rid of Hamas and make sure Hamas is not a threat to Israel.”

US President Donald Trump’s administration was consulted by Israel before it carried out the strikes, officials said.

The US National Security Council spokesman Brian Hughes said “Hamas could have released hostages to extend the ceasefire, but instead chose refusal and war.”

Hamas warned the resumption of violence by Israel would “impose a death sentence” on the remaining living hostages held in Gaza, and accused Israel of trying to force it into a surrender.

A group representing hostages’ families has accused the Israeli government of choosing “to give up the hostages” by launching new strikes – and has been protesting outside the Israeli parliament.

Israel says Hamas is still holding 59 hostages, 24 of whom are believed to be alive.