RAFAH, Gaza Strip — The U.N. food agency said Monday that “famine is imminent” in northern Gaza, where 70% of the remaining population is experiencing catastrophic hunger, and that a further escalation of the war could push around half of Gaza’s total population to the brink of starvation.

The alarming report came as Israel faces mounting pressure from even its closest allies to streamline the entry of aid into the Gaza Strip and open more crossings. The European Union’s top diplomat said the impending famine was “entirely man-made” as “starvation is used as a weapon of war.”

Israeli forces meanwhile launched another raid on the Gaza Strip’s largest hospital early Monday, saying Hamas militants had regrouped there and had fired on them from inside the compound, where Palestinian officials say tens of thousands of people have been sheltering.

The military said it killed a Hamas commander who was armed and hiding inside the medical center, and that one of its own soldiers was killed in the operation.

Rafah Offensive Could Push Half of Gaza to Starvation

The World Food Program on Monday released the latest findings of its Integrated Food Security Phase Classification, or IPC, an international process for estimating the scale of hunger crises.

It says virtually everyone in Gaza is struggling to get enough food, and that around 677,000 people — nearly a third of the population of 2.3 million — are experiencing the highest level of catastrophic hunger. That includes around 210,000 people in the north.

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It warned that if Israel broadens its offensive to the packed southern city of Rafah, as Prime Minister Benjamin Netanyahu has repeatedly vowed, the fighting could drive over a million people — half of Gaza’s population — into catastrophic hunger.

“This is the largest number of people facing imminent famine in the world today, and it has only taken five months to occur,” said Matthew Hollingworth, the acting World Food Program country director for the Palestinian territories.

“It’s still possible to turn this around but there has to be a cease-fire and there has to be massive amounts of food aid to flow consistently, and people need to have access to clean water and health care,” he said.

‘We’re Trapped Inside’

The heavy fighting around Shifa Hospital, in the heart of Gaza City, meanwhile pointed to the continuing presence of Palestinian militants in northern Gaza despite the harsh conditions there.

People sheltering in the hospital said Israeli forces backed by tanks and artillery had surrounded the medical complex and that snipers were shooting at people inside. They said the army raided a number of buildings and detained dozens of people.

“We’re trapped inside,” said Abdel-Hady Sayed, who has been sheltering in the medical facility for over three months. “They fire at anything moving. … Doctors and ambulances can’t move.”

Gaza’s Health Ministry said around 30,000 people are sheltering at the hospital, including patients, medical staff and people who have fled their homes seeking safety. The war has displaced around 80% of Gaza’s population.

The United States, Qatar and Egypt have spent weeks trying to broker another cease-fire and hostage release, but the gulf between the two sides remains wide, with Hamas demanding guarantees for an end to the war and Israel vowing to continue the offensive until it destroys the militant group.