JERUSALEM (AP) — Israel launched its offensive in Gaza City on Tuesday, vowing to overwhelm a city already in ruins from nearly two years of war as thousands of Palestinians fled in vehicles strapped with mattresses and other belongings that clogged a coastal road.

The operation into the largest Palestinian city escalated a conflict that has roiled the Middle East and likely pushed any ceasefire with Hamas farther out of reach. The military would not offer a timeline for the offensive that aims to crush the militant group's ability to fight, but Israeli media suggested it could take months.

“Gaza is burning,” Israeli Defense Minister Israel Katz declared as the operation began. Heavy bombardment pounded the city, and troops began moving in from the outskirts after weeks of airstrikes and buildup toward the renewed assault.

The offensive began the same day that independent experts commissioned by the United Nations Human Rights Council accused Israel of committing genocide in Gaza. Israel rejected the allegation, calling the report “distorted and false.”

One woman, Saud al-Sakani, said her daughter, son-in-law and their children were killed in a strike that flattened their home with about 40 people inside. “An entire family!” she cried, weeping over their bodies at Shifa Hospital’s morgue. “Many are still under the rubble.”

On a brief visit to the region, U.S. Secretary of State Marco Rubio warned that there was a “very short window of time in which a deal can happen” to end the war.

Meanwhile, a missile fired by Iran-backed Houthi rebels in Yemen set off rocket sirens in Jerusalem and Tel Aviv. The Israeli military said it was working to intercept the projectile, which was fired after Israel carried out airstrikes on the rebel-held port city of Hodeida in Yemen.

The Houthis have regularly fired drones and missiles at Israel in what they say is solidarity with the Palestinians. The vast majority have been intercepted or landed in open areas without causing casualties or damage. Israel has carried out waves of retaliatory strikes on Yemen.

Palestinians flee Gaza City

Israeli forces have carried out multiple large-scale raids into Gaza City over the course of the war, causing mass displacement and heavy destruction, only to see militants regroup later. This time, Israel has pledged to take control of the entire city, which experts say is experiencing famine.

An Israeli military official, speaking on condition of anonymity in line with military guidelines, said the “main phase” of the Gaza City operation had begun and troops had started moving.

The official said the Israeli military believes there are 2,000 to 3,000 Hamas militants left in Gaza City, as well as tunnels used by the group. Hamas’ military capabilities have been vastly diminished over nearly two years of war. It now mainly carries out guerrilla-style attacks, with small groups of fighters planting explosives or attacking military outposts before melting away.

Ismail Zaydah, 39, said he fled from his home in Gaza City’s Sheikh Radwan neighborhood to an area near the coastal road. He said trucks carrying people south to an Israeli-designated humanitarian zone charge around $1,000, even as many families in Gaza City are starving.

“We fled with nothing but a few pieces of clothing. People are pitching their tents in western Gaza City, and they are sleeping among human waste because there is no place for them to go,” he said.

An estimated 1 million Palestinians were living in the Gaza City region before warnings to evacuate began ahead of the offensive, and the Israeli military estimates 350,000 people have left the city.

A U.N. estimate on Monday said that over 220,000 Palestinians have fled northern Gaza over the past month. But hundreds of thousands more have stayed behind.

By the end of the current operation, an Israeli military graphic suggested its troops hope to control all of the Gaza Strip except for a large swath along the coast.

At least 69 Palestinians killed in city

Palestinian residents reported heavy strikes across Gaza City on Tuesday morning, with hospitals in the city reporting at least 69 deaths.

“A very tough night in Gaza,” Dr. Mohamed Abu Selmiya, the director of Shifa Hospital, told The Associated Press. “The bombing did not stop for a single moment.”

Several women gathered at the hospital’s morgue, where AP footage showed many dead in body bags.

Shifa received the bodies of 49 people, including 22 children, according to Dr. Rami Mhanna, a hospital official, who said dozens of wounded had also come into the facility. Al-Ahli Hospital received 17 bodies, and Al-Quds three.

The Israeli military did not immediately respond to requests for comment on the deadly strikes but in the past has accused Hamas of building military infrastructure inside civilian areas.

The war in Gaza began when Hamas-led militants stormed into southern Israel on Oct. 7, 2023, killing around 1,200 people, mostly civilians, and abducting 251. Forty-eight hostages, fewer than half believed to be alive, remain in Gaza.

Israel’s retaliatory offensive has killed more than 64,900 Palestinians, according to Gaza’s Health Ministry, which does not say how many were civilians or combatants. The ministry, which is part of the Hamas-run government and staffed by medical professionals, says women and children make up around half the dead.

Families of hostages beg Netanyahu to halt the operation

Overnight, families of the hostages still being held in Gaza gathered outside Prime Minister Benjamin Netanyahu's residence, imploring him to stop the offensive.

“Netanyahu gave the order to bomb my child," said Anat Angrast, whose son is held in Gaza. “He knows that Matan is in immediate danger due to the Gaza operation, yet he decided to bomb him to death. He is the only one who will decide whether Matan lives or dies.”

Israel believes around 20 of the hostages are alive. Hamas has said it will only free remaining captives in return for Palestinian prisoners, a lasting ceasefire and an Israeli withdrawal from Gaza.

On a visit to Israel, Rubio suggested that there might still be time for a negotiated end the war.

“At some point, this has to end. At some point, Hamas has to be defanged, and we hope it can happen through a negotiation,” he said. “But I think time, unfortunately, is running out.”

He continued to Qatar, where he met with its ruling emir. Qatar is incensed over an Israeli strike last week that killed five Hamas members and a local security official.

Rubio thanked Qatar, which has been a key negotiator in efforts to reach a ceasefire, for playing that role, according to a statement from his office, which did not directly acknowledge the Israeli strike. He also highlighted the countries’ close ties.

Arab and Muslim nations denounced the strike at a summit Monday but stopped short of any major action targeting Israel.

Egypt escalates its rhetoric against Israel

Egypt, which has had a peace deal with Israel for decades and has also served as a mediator in the war, appears to be losing its patience.

Egypt's president, Abdel-Fattah el-Sissi, described Israel as “an enemy” in a fiery speech at the Qatar summit Monday. It was the first time an Egyptian leader used the term since the two countries established diplomatic ties in 1979, said Diaa Rashwan, head of Egypt's State Information Service.

Egypt was the first Arab country to establish ties with Israel, and their peace treaty is seen as a cornerstone for stability in the volatile region.

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Gambrell reported from Dubai, United Arab Emirates, and Magdy reported from Cairo. Associated Press writers Matthew Lee in Munich, Germany, and Josef Federman in Jerusalem contributed to this report.