When U.S. Secretary of State Antony Blinken lamented the number of civilian deaths in Gaza on Friday, it marked a subtle but notable shift in American language toward the Israeli government.

For weeks, the Biden administration strongly supported Israeli Prime Minister Benjamin Netanyahu’s military offensive following the brutal Hamas attack, but the rising death toll in the besieged enclave, huge pro-Palestinian protests across the world and growing discomfort within the White House have put considerable strain. pressure on the American posture.

“Far too many Palestinians have been killed. Far too many people have suffered in recent weeks,” said the top US diplomat in New Delhi. “We want to do everything we can to avoid any harm and maximize the help that reaches them. »

“To this end, we will continue to discuss with Israel concrete steps to advance these goals,” Blinken added.

Administration officials say they have achieved success in some areas as they work to ease the humanitarian crisis in Gaza. The White House said Thursday that Israel had agreed to daily four-hour pauses in military operations in areas of northern Gaza.

But the Biden administration’s continued pressure on Israel to refine its war plans and define its goals in Gaza has not provided the level of clarity many U.S. officials desire.

To date, more than 11,000 Palestinians have been killed in Israeli attacks on Gaza since October 7, according to the Palestinian Health Ministry in Ramallah, from sources in Hamas-controlled territory.

The ferocity of the military operation shows no signs of slowing. Israeli tanks surrounded a Gaza hospital on Friday, its director told CNN, as the territory’s largest health facility came under “bombardment.”

Mustafa al-Kahlout, who runs Al Nasr Hospital and Al Rantisi Pediatric Hospital in northern Gaza, told CNN they were surrounded and asked the Red Cross to help carry out a evacuation. “We are completely surrounded, there are tanks outside the hospital and we cannot leave,” al-Kahlout said.

The Israeli military said Hamas was embedding itself in civilian infrastructure and that it would strike Hamas “wherever necessary.” CNN cannot verify these claims.

Netanyahu insisted Thursday that there would be “no ceasefire” without the release of hostages held by Hamas.

A growing number of Israelis share this view, saying their country should immediately begin negotiations with Hamas for the release of hostages held in Gaza – but should continue to fight while negotiating, a published survey suggests Friday.

Nearly four in ten Israelis (38%) expressed this opinion in a survey conducted by the Viterbi Family Center for Public Opinion and Political Research at the Israel Democracy Institute. That’s up from 32 percent who said Israel should negotiate while fighting in the last survey conducted about two weeks earlier.

“The fighting continues and there will be no ceasefire without the release of our hostages,” Netanyahu said in a statement.

But a broader deal to free the hostages has proved impossible, and frustration with the government’s response is growing. Last weekend, hundreds of family members of the hostages gathered in Tel Aviv to demand that authorities do more to secure their freedom. And a strongly worded statement issued last week by the Hostages and Missing Families Forum spoke of “enormous anger” that the government was not telling them about the Gaza operation.

Meanwhile, major cities around the world, including London, Istanbul, New York, Baghdad and Rome, have seen their centers filled with pro-Palestinian protesters calling for a ceasefire, with more demonstrations planned this weekend -end.

Video of a protest in Washington, D.C., last weekend showed a huge crowd, many wearing kaffiyehs – a patterned headscarf that has become a symbol of Palestinian identity – and waving Palestinian flags. “Stop the massacre” and “Let Gaza live” read signs in the audience.

Many protesters addressed Biden directly, chanting “Biden, Biden, you can’t hide, we accuse you of genocide” and “no ceasefire, no votes.”

After Biden was confronted by a protester calling for a ceasefire at a private fundraiser last week, National Security Council spokesman John Kirby told reporters that “President understands that there are strong emotions and feelings here, everywhere, in all areas – and here within.” the administration and the federal government, this is certainly also the case.”

“We have collaborated with partners, organizations, experts, analysts and people with different perspectives, to listen to their concerns and make sure we understand them when we develop policy,” Kirby said.

Concerns about the widening conflict and possible diplomatic fallout abroad also remain a major concern in the United States.

The Biden administration has received stark warnings from U.S. diplomats in the Arab world that its strong support for Israel’s military campaign is “losing us a generation of Arab publics,” according to a diplomatic cable obtained by CNN.

American support for Israel’s actions is seen, the cable warns, “as material and moral culpability in what they consider possible war crimes.”

And in the Middle East, Iranian proxy groups have intensified attacks on U.S. forces and assets in the region in recent weeks, following Hamas’ attack on Israel.

U.S. and coalition bases in Iraq and Syria have been attacked at least 40 times since Oct. 17, leaving several U.S. service members with head trauma and other injuries, all minor, officials said.

Two U.S. airstrikes aimed at deterring attacks have not stopped the militias.

A U.S. official told CNN on Thursday that U.S. and coalition forces had been attacked at least four more times after the latest U.S. strike in eastern Syria on Wednesday.

Blinken reiterated Friday that the United States “will continue to focus relentlessly on the return of our hostages” and stopping the expansion of the conflict.

Speaking in India on Friday, Blinken insisted that “some progress has been made” in the week since meeting in Tel Aviv with Netanyahu and other Israeli officials, but “it is a process and it is isn’t always about flipping the switch.”

Yet public messages — from Blinken and other U.S. officials — continued to emphasize Israel’s right to defend itself and reject any calls for a ceasefire.

The administration acknowledges publicly and privately that there can be no stopping the fighting now as the next phase of the offensive unfolds.

At a news conference Wednesday, Blinken sought to clarify that position, even as pressure continues to mount at home and abroad.

“Those calling for an immediate ceasefire have an obligation to explain how to deal with the unacceptable outcome that could result. »

CNN Jennifer Hansler, Kevin Liptak, MJ Lee And Alex Marquardt contributed to this report.

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