by Sanaa Kamal

GAZA, March 18 (Xinhua) -- Gaza's streets trembled anew on Tuesday as thunderous explosions shattered the predawn calm, thrusting residents into a nightmare reminiscent of the conflict's earliest days.

Without warning, Israeli forces unleashed a barrage of some 80 airstrikes across the besieged enclave within about 10 minutes. The attacks have killed over 400 people and injured hundreds more, according to the Gaza-based health authorities.

In neighborhoods reduced to labyrinths of debris, paramedics clawed through rubble with bare hands, pulling bodies and the wounded from broken houses. Overwhelmed hospitals, whose corridors were strewn with bloodied survivors, corpses, and desperate families searching for beloved ones, teetered on the edge of collapse.

"We are facing a real health disaster," Mohammed Abu Salmiya, a senior health official, told Xinhua. "Emergency rooms are full, medical equipment is scarce, and generators are running on the last drops of fuel."

The latest assault reignited collective trauma. Hanan Muhanna, a Palestinian mother in Gaza City, had been preparing suhoor -- the pre-dawn meal during the Muslim holy month of Ramadan -- when explosions rocked her home.

"Everything turned upside down ... It was hell itself," she told Xinhua, her voice quivering. "It's as if we've returned to the first days of the war. People are starving, and Ramadan has arrived in Gaza under the shadow of famine."

"We lived on a terror night. The children kept screaming, and the house was shaking under the bombing ... No one knew if they would survive the night," she said.

In Rafah's Mawasi area, Umm Muhammad huddled with her five children in a tent. "We were sleeping when a missile fell on the house next door. The neighbors dug us out with their bare hands. We have no food, no water. The children are sleeping on the ground," she told Xinhua.

On Tuesday, Israeli Foreign Minister Gideon Sa'ar said the initial decision to launch the attacks was made "several days ago."

He also confirmed that officials with U.S. President Donald Trump's administration "were informed before the attacks and supported it."

In the eyes of political analyst Raed Najm, the renewed Israeli attacks were not surprising at all.

Israel's tightened aid and electricity blockade on Gaza, the following intense bombing on the enclave, as well as the issuance of evacuation orders for residents of certain areas, all indicate its intention to carry out a new ground incursion into Gaza, Najm told Xinhua.

Later on Tuesday, Israeli Prime Minister Benjamin Netanyahu claimed that the overnight attack was launched because Hamas rejected Israeli and U.S. proposals to extend the first phase of the Gaza ceasefire deal that ended on March 1. The proposals demanded prolonging the first phase and Hamas freeing additional hostages.

"The recent strikes effectively ended any talk of a truce agreement and brought the conflict into a new phase that may be more complex than before," putting the region on the brink of a new confrontation open to multiple possibilities, Ramallah-based Palestinian political analyst Ismat Mansour told Xinhua.