The Palestinian death toll in Israel's genocidal Gaza war crossed 42,000 on Wednesday when a large-scale Israeli operation in northern Gaza killed dozens of people, officials confirmed.

It also threatened to shut down three hospitals over a year into the war, residents said.

Heavy fighting is underway in Jabalia, where Israeli forces have carried out several major operations throughout the war and then returned as resistance members regroup. The entire north, including Gaza City, has suffered heavy destruction and has been largely isolated by Israeli forces since late last year.

The continuing cycle of destruction and death in Gaza, unleashed by Hamas' Oct. 7, 2023 incursion of southern Israel, comes as Israel expands a weeklong ground offensive against Hezbollah in Lebanon and considers a major retaliatory strike on Iran.

A rocket fired from Lebanon killed two people in the northern Israeli town of Kiryat Shmona and another six people were wounded in a series of stabbings in the city of Hadera on Wednesday, which Israeli police described as a militant attack. The police said the attacker was "neutralized," indicating he was killed.

Residents of Jabalia, a refugee camp dating back to the 1948 war surrounding Israel's creation, said thousands of people have been trapped in their homes since the operation began Sunday, as Israeli jets and drones buzz overhead and troops battled in the streets.

"It’s like hell. We can’t get out," said Mohamed Awda, who lives with his parents and six siblings. He said three bodies in the street outside his home could not be retrieved because of the fighting.

"The quadcopters are everywhere and they fire at anyone. You can’t even open the window," he told The Associated Press by phone, speaking over the sound of explosions.

Gaza's Health Ministry said it recovered 40 bodies from Jabalia from Sunday until Tuesday and another 14 from communities farther north. There are likely more bodies under rubble and in areas that can't be accessed, it said.

An airstrike in Jabalia early Wednesday killed at least nine people, including two women and two children, according to Al-Ahli Hospital, which received the bodies. Strikes in central Gaza killed another nine people, including three children, according to Al-Aqsa Martyrs Hospital in Deir al-Balah.

Residents of Jabalia fear Israel aims to depopulate the north and turn it into a closed military zone or a Jewish settlement. Israel has blocked all roads except for the main highway leading from Jabalia to the south, according to residents.

The U.N. agency for Palestinian refugees said it was evacuating seven schools that were being used as shelters and that only two of eight water wells in the camp are still functioning.

"We are concerned about the displacement to the south," Ahmed Qamar, who lives in Jabalia with his wife, children and parents, said in a text message. "People here say clearly that they will die here in northern Gaza and won’t go to southern Gaza."

Fadel Naeem, the director of Al-Ahli Hospital in Gaza City, said it had received dozens of wounded people and bodies from the north. "We declared a state of emergency, suspended scheduled surgeries, and discharged patients whose conditions are stable," told AP in a text message.

Israel’s offensive has gutted Gaza’s health sector, forcing most of its hospitals to shut down and leaving the rest only partially functioning.

Naeem said three hospitals farther north – Kamal Adwan, Awda and the Indonesian Hospital – have become almost inaccessible because of the attacks. The Gaza Health Ministry says the Israeli army has ordered all three to evacuate staff and patients. Meanwhile, no humanitarian aid has entered the north since Oct. 1, according to U.N. data.

The Israeli military did not immediately respond to requests for comment on the hospitals or the apparent suspension of aid delivery in the north.

Rear Adm. Daniel Hagari, the military spokesperson, said late Tuesday that Israeli forces were operating in Jabalia to "prevent Hamas' regrouping efforts" and had killed around 100 resistance members, without providing evidence.

Israel ordered the wholesale evacuation of northern Gaza, including Gaza City, in the opening weeks of the war, but hundreds of thousands of people are believed to have remained there. Israel reiterated those instructions over the weekend, telling people to flee south to an expanded humanitarian zone where hundreds of thousands are already crammed into squalid tent camps.

The war began just over a year ago, when Hamas members stormed into southern Israel, causing around 1,200 deaths and abducting around 250. They are still holding around 100 hostages, a third of whom are believed to be dead.

Besides 42,000 dead Palestinians, Israel's offensive has caused staggering destruction across the territory and displaced around 90% of the population of 2.3 million people, often multiple times.