US President Joe Biden said Hamas was committing war crimes by having its military headquarters under a hospital, repeating a statement made by a White House spokesperson on Tuesday, and he was confident about the US intelligence supporting that “fact”.

He insisted Israel had gone into Gaza’s biggest hospital, Al Shifa, with a limited number of troops with guns, and was not carpet-bombing the site.

“They were told … we discussed the need for them to be incredibly careful,” Biden said, adding that Israel had an obligation to use as much caution as possible in going after targets.

But he said it was “not realistic” to expect Israel to stop its military actions, given threats by senior Hamas officials that they intended to attack Israel again.

He said Israel was also bringing in incubators and other equipment to help people, and were giving doctors, nurses and other staff the opportunity to “get out of harm’s way”.