The White House on Tuesday said it had its own intelligence that Hamas was using Gaza's largest hospital Al Shifa to run its military operations, and probably to store weapons, saying those actions constituted a war crime.
"We have information that confirms that Hamas is using that particular hospital for a command and control mode" and probably to store weapons, national security spokesperson John Kirby told reporters aboard Air Force One. "That is a war crime."
He said the United States had information that Hamas and the Palestinian Islamic Jihad were using some hospitals in the Gaza Strip, including Al Shifa, to conceal or support their military operations and to hold hostages.
He said those groups were also prepared to respond to Israeli military operations against that facility.
That information came from a variety of intelligence methods, he said, adding that the Biden administration had downgraded the classification level of some of the data on Tuesday so it could share its conclusions with reporters.
Kirby underscored that Hamas' actions in the hospitals did not lessen Israel's responsibility to protect civilians, but acknowledged that it made Israel's efforts to root out Hamas more complicated.
"To be clear, we do not support striking a hospital from the air. We do not want to see a firefight in a hospital where innocent people, helpless people, sick people are simply trying to get the medical care they deserve," he said.
"We have been clear on multiple occasions - Hamas actions do not lessen Israel's responsibilities to protect civilians in Gaza, and this is something we're going to continue to have an active conversation with our counterparts about," he added.
Israeli forces have surrounded Gaza City's Al Shifa hospital, the biggest in the enclave, which they say sits atop an underground headquarters of Hamas militants.
Hamas, Gaza's ruling Islamist group, denies fighters are present and says 650 patients and 5,000-7,000 other civilians are trapped inside the hospital grounds, under constant fire from snipers and drones. It says 40 patients have died in recent days, including three premature babies whose incubators were knocked out.
A Hamas official in Beirut said 25 of Gaza's 35 hospitals were out of use because of Israel's assault. The fate of Al Shifa in particular has become a focus of international alarm, including from Israel's closest ally, the United States.
Israel denies the hospital is under siege and says its forces allow exit routes for those inside. Medics and officials inside the hospital deny this and say those trying to leave come under fire. Reuters could not verify the situation.