At least 70 people were killed and 280 were wounded as Palestinians rushed toward trucks loaded with humanitarian aid and encountered fire in Gaza City early Thursday, according to local media reports. 

The exact circumstances surrounding the deaths remain unclear; while several reports suggested Israeli troops fired on the crowd as they descended upon the trucks, the Israeli military suggested that most who died were trampled.

"Early this morning, during the entry of humanitarian aid trucks into the northern Gaza Strip, Gazan residents surrounded the trucks, and looted the supplies being delivered," Israeli Defense Forces (IDF) said in a statement. "During the incident, dozens of Gazans were injured as a result of pushing and trampling. The incident is under review."

IDF suggested that fewer than 10 civilians were injured by Israeli forces opening fire during the delivery of humanitarian aid, and that most deaths and injuries came from the stampede.

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The deadly incident took place at al-Nabusi roundabout west of Gaza City in the northern part of the enclave, Gaza Health Ministry spokesperson Ashraf al-Qidra said.

Fares Afana, the head of the ambulance service at the Kamal Adwan Hospital, said medics arriving at the scene found "dozens or hundreds" lying on the ground. He said there were not enough ambulances to collect all the dead and wounded and that some were being brought to hospitals on donkey carts.

Dr Hussam Abu Safia, director of the Kamal Adwan Hospital, said emergency personnel are struggling to cope with the influx of patients. 

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"Most of our patients are in critical condition, which requires urgent surgical intervention, but we have no operating rooms," Abu Safia told Al Jazeera.

"I stand helpless. We are simply administering first-aid treatment only."

Hamas says it holds Israel, President Biden and his administration "fully responsible" for the incident and for the "ethnic cleansing" of its people. The group called for worldwide demonstrations against Israel's bombardment of Gaza. 

"We have mercy on the souls of our people’s martyrs, and we affirm that their sacrifices and blood will not be in vain and that we will remain loyal to our cause, our land, and our sanctities," the group posted to Telegram.

Gaza City and the rest of northern Gaza were the first targets of Israel's air, sea and ground offensive launched in response to Hamas' Oct. 7 attack in which militants crossed the border from Gaza and massacred some 1,200 people. The area has suffered widespread devastation and has been largely isolated from the rest of the territory for months, with little aid entering.

The Health Ministry said the Palestinian death toll from the war has climbed to 30,035, with another 70,457 wounded. It does not differentiate between civilians and combatants in its figures but says women and children make up around two-thirds of those killed.

Reuters and The Associated Press contributed to this report.