When US Secretary of State Antony Blinken lamented the civilian death toll in Gaza on Friday, it marked a subtle but notable shift in US language toward the Israeli government.

For weeks, the Biden administration has strongly backed Israeli Prime Minister Benjamin Netanyahu’s military offensive following Hamas’ brutal attack, but a rising death count in the besieged enclave, enormous pro-Palestinian protests across the globe and increasing discomfort inside the White House has put considerable strain on the US’ posture.

“Far too many Palestinians have been killed. Far too many have suffered these past weeks,” the top US diplomat said in New Delhi. “We want to do everything possible to prevent harm to them and to maximize the assistance that gets to them.”

“To that end, we’ll be continuing to discuss with Israel the concrete steps to be taken to advance these objectives,” Blinken added.

Administration officials argue they have had success in some areas as they work to alleviate the humanitarian crisis in Gaza. The White House said Thursday that Israel had agreed to move forward with daily four-hour pauses of military operations in areas of Northern Gaza.

But steady pressure by the Biden administration on Israel to refine its war plans and define its objectives in Gaza has not yielded the level of clarity many US officials want.

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

The ferocity of the military operation shows no sign of letting up. On Friday, Israeli tanks surrounded a Gaza hospital, its director told CNN, as the territory’s largest healthcare facility came under a reported “bombardment.”

Mustafa al-Kahlout, who heads the Al Nasr hospital and Al Rantisi Pediatric hospital in northern Gaza, told CNN that they were surrounded and asked for the Red Cross to assist with an evacuation. “We are completely surrounded, there are tanks outside the hospital, and we cannot leave,” al-Kahlout said.

The IDF has said Hamas is embedding itself in civilian infrastructure and that it will strike Hamas “wherever necessary.” CNN cannot verify those claims.

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

An increasing number of Israelis share that view, saying their country should immediately begin negotiations with Hamas for the release of hostages held in Gaza – but should continue fighting while negotiating, a survey published Friday suggests.

Nearly four out of 10 Israelis (38%) expressed the opinion in a survey by the Viterbi Family Center for Public Opinion and Policy Research at the Israel Democracy Institute. That’s a rise from 32% saying Israel should negotiate while fighting when the survey was last 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 so far a wider deal to free the hostages has proved elusive, and frustration with the government’s response is growing.

On Friday, CNN reported that the parties involved in the ongoing negotiations to secure the release of hostages are working toward a deal that would entail a sustained, dayslong pause in fighting in exchange for a large group of hostages being freed, a senior US official familiar with the talks said.

If a deal were to be struck, the hostages would exit Gaza in stages on a rolling basis – with priority placed on extra vulnerable groups like children and women – in a process that is expected to take multiple days, the official said.

Still, they repeatedly cautioned that the talks could at any point stall or deteriorate: “It’s been close before. There’s no certainty at all.”

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

Video from a demonstration in Washington, DC, last weekend showed an enormous crowd, many of them wearing the kaffiyeh – a patterned scarf that has become a symbol of Palestinian identity – and carrying Palestinian flags. “Stop the massacre” and “Let Gaza live” read signs in the audience.

Many protestors directly addressed Biden, leading chants of “Biden, Biden, you can’t hide, we charge you with genocide” and “no ceasefire, no votes.”

After Biden was confronted by a protestor calling for a ceasefire at a private fundraiser last week, National Security Council spokesman John Kirby told reporters that “the president understands that there’s strong emotions and feelings here, all around, all across the board – and here inside the administration and the federal government, that’s certainly the case as well.”

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

Concerns about the conflict widening and the potential for further diplomatic fallout overseas remain top of mind in the US as well.

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

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

And in the Middle East, Iranian proxy groups have stepped up their attacks on US forces and assets in the the area in recent weeks following Hamas’ attack on Israel.

US and coalition bases in Iraq and Syria have been attacked at least 40 times since October 17, leaving multiple US servicemembers with traumatic brain injuries and other injuries, all of which have been minor, officials said.

Two US airstrikes aiming to deter the attacks have not stopped the militias.

On Thursday, a US official told CNN that US and coalition forces have come under attack at least four more times following the most recent US strike in eastern Syria on Wednesday.

Blinken reiterated Friday that the US “will continue to focus relentlessly on getting our hostages home” and stopping the conflict from expanding.

Speaking in India Friday, Blinken insisted “some progress has been made” in the week since he met in Tel Aviv with Netanyahu and other Israeli officials, but “this is a process and it’s not always flipping the light switch.”

Still, the public messaging – from Blinken and other US officials – has continued to emphasize Israel’s right to defend itself and rebuff any calls for a ceasefire.

There are public and private acknowledgements from the administration that there cannot be a stop to the fighting right now as the next phase of the offensive plays out.

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

“Those calling for an immediate ceasefire have an obligation to explain how to address the unacceptable result that would likely bring.”