The American death toll rose to 22 and Israeli fatalities surpassed 1,200 Wednesday while desperation swept across Gaza as Tel Aviv’s response to the brutal attack by Hamas left neighborhoods destroyed, homes dark and hospitals low on medical supplies.

“At this time, we can confirm the deaths of at least 22 U.S. citizens,” the State Department said in a statement. “We extend our deepest condolences to the victims and to the families of all those affected.”

Israeli soldiers retaking communities near the Gaza border, encountered streets littered with the bodies of civilians, including women and children. The Israeli health ministry said the death toll is likely to increase amid continued fighting and the discovery of more bodies in the settlements.

Palestinian officials say more than 1,100 militants and citizens in Gaza have been killed and more than 5,000 wounded. Israeli rockets smashed into neighborhoods for a fifth day Wednesday, destroying homes and infrastructure.

The territory, home to more than 2 million Palestinians, faced the grim prospects of a complete blackout and limited supplies of food and water. The head of Gaza’s Energy Authority told Al Jazeera Mubasher the enclave’s only power plant ran out of fuel Wednesday. The U.N.’s World Health Organization said supplies pre-positioned at hospitals were depleted.

“We will not allow a reality in which Israeli children are murdered,” Israeli Defense Minister Yoav Gallant said in a meeting with soldiers. “I have removed every restriction. We will eliminate anyone who fights us, and use every measure at our disposal.”

Hamas denied targeting children and issued a statement condemning Western media for “promoting the Israeli occupation’s propaganda, which is full of lies and fabrications, as an attempt to cover up the crimes and massacres committed by the Israeli occupation around the clock.”