Israel has agreed to put in place four-hour daily humanitarian pauses in its assault on Hamas in northern Gaza starting on Thursday, the White House said, even as President Joe Biden claimed that there was “no possibility” of a formal cease-fire at the moment, and said it had “taken a little longer" than he hoped for Israel to agree to the humanitarian pauses.

The month-old war has killed over 10,500 civilians in Gaza, its health ministry said. On Thursday,?Israeli ground forces battled near Gaza's largest hospital, Shifa, where?thousands of people are sheltering.?Families are sleeping in hospital rooms, even surgical theatres and the maternity ward, or on the streets outside.

“The conditions here are disastrous in every sense of the word," the director Mohammed Abu Selmia told The Associated Press on Thursday. “We're short on medicine and equipment, and the doctors and nurses are exhausted. … We're unable to do much for the patients."

During a brief call with Netanyahu on Monday, Biden had urged him to institute daily pauses, starting first with a pause of at least three days to allow for negotiations over the release of some hostages held by Hamas. “Yes,” Biden said, when asked whether he had asked Israel for a three-day pause. “I've asked for even a longer pause for some of them.”

National Security Council spokesman John Kirby said that the first daily humanitarian pause would be announced on Thursday and that the Israelis had committed to announcing each four-hour window at least three hours in advance.

Israel is also was opening a second corridor for civilians to flee the areas that are the current focus of its military campaign against Hamas, with a coastal road joining the territory's main north-south highway, Kirby said.

Thursday's announcement appeared to be an effort to formalise the process of initiating pauses in the war,?as the US has pressed Israelis to take greater steps to protect civilians in Gaza. Biden's push for an even longer pause comes as part of a renewed diplomatic push to free hostages taken by Hamas and other militant groups to the Gaza Strip during their October 7 surprise attack on Israel.

Kirby told reporters on Thursday that pauses could be useful to “getting all 239 hostages back with their families to include the less than 10 Americans that we know are being held. So if we can get all the hostages out, that's a nice finite goal”.“Humanitarian pauses can be useful in the transfer process,” he added. Israeli officials estimate that militants still hold 239 hostages, including children and the elderly, from the attack that also saw 1,400 Israelis killed. US officials say it believes fewer than 10 Americans are among those held captive.