An Israeli strike in northern Gaza killed scores of people in a building where refugees fled, officials there said.

An Israeli strike on a five-story building where Palestinians have been sheltering in the northern Gaza Strip killed at least 60 people early Tuesday, more than half of them women and children, the Health Ministry in Hamas-run Gaza said.

Dr. Marwan al-Hams, director of Gaza’s hospital department, announced the number of people in Tuesday’s strike in the northern city of Beit Lahiya at a press conference, adding that 17 other people were missing.

Reuters news agency reported that the Palestinian Civil Emergency Service said many people are believed to be still trapped under the rubble.

Health department emergency personnel said the dead included at least 12 women and 20 children, including infants.

The Israeli army, which has been conducting a major operation in northern Gaza for more than three weeks, was not immediately noticed, targeting the pockets of Hamas that have gathered there.

Dr. Hossam Abu Safiya, director of the nearby Kamal Adwan Hospital, said he was overwhelmed by the wave of people injured in the strike.

Israeli soldiers raided the medical center over the weekend, arresting dozens of paramedics, the latest in a series of hospital raids since the start of the war. The army claimed to have arrested dozens of Hamas fighters during the raid on Kamal Adwan.

The Israeli military has repeatedly attacked shelters for displaced people in recent months, saying it carried out direct strikes on Palestinian villages and tried to avoid harming civilians. The strikes often kill women and children.

Reuters news agency put the death toll in the strike at 55 or more, with dozens injured 55 Palestinians were killed and dozens were injured in an Israeli strike on a building in northern Gaza, Beit Lahiya on Tuesday, the Palestinian Civil Emergency Service said.

It also said that many victims are still believed to be trapped under the rubble.

Israel’s latest major offensive in northern Gaza, centered on the Jabaliya refugee camp, has killed hundreds of people and driven tens of thousands from their homes in another wave of mass displacement in more than a year of fighting in the small coastal enclave.

Israel also severely restricted aid to the north this month, leading to a warning from the United States that failure to undertake major aid efforts could lead to a reduction in military aid.

The Palestinians fear that Israel is carrying out a plan proposed by a group of former generals who have suggested that residents of the north should be ordered out, aid services cut off, and anyone who remains there treated as a traitor.

The military denies that it is carrying out such a program, and the government has not said whether it is running all or part of it.