Negotiations involving multiple countries and high-level delegations on a Gaza ceasefire deal have entered a second day in the Egyptian capital, Cairo, as mediators struggle to make progress in the face of a threatened Israeli offensive on Rafah, the Palestinian territory’s last place of relative safety. Benjamin Netanyahu vowed to press ahead with an offensive, but only after civilians are allowed to leave the “battle zones”. The Israeli prime minister did not make clear where the trapped civilians would be permitted to go, and what safeguards, if any, would be put in place to protect them. More than a million Palestinians are sheltering in the city. The UN coordinator for relief operations, Martin Griffiths, warned that an offensive “could lead to a slaughter in Gaza”, and in a phone call with Netanyahu, the French president, Emmanuel Macron, said the Gaza death toll was “intolerable” and insisted the Israeli offensive “must cease”. Diplomatic efforts continued meanwhile, with the aim of salvaging a new hostage and ceasefire deal that would forestall the offensive. Representatives for the Palestinian militant group Hamas were expected in Cairo on Wednesday, and Turkey’s president, Recep Tayyip Erdoğan, arrived on his first visit to Egypt after more than a decade of tensions between the regional powers over support for the Muslim Brotherhood. Erdoğan said discussions with the Egyptian president, Abdel Fatah al-Sisi, who came to power in a 2013 coup, would focus on Israel’s offensive in Gaza. On Tuesday Israel made a last-minute decision to send a delegation led by its heads of intelligence, David Barnea of the Mossad and Ronen Bar of the Shin Bet, which met US, Egyptian and Qatari mediators. The CIA director, William Burns, joined Egypt’s intelligence director, Abbas Kamel, and the Qatari prime minister, Sheikh Mohammed bin Abdulrahman Al Thani, for a day of talks that the US national security council spokesperson, John Kirby, said had been “constructive”, though Egypt’s state information service said it had concluded without any significant breakthrough. This round of negotiations, aimed at a lengthy ceasefire and a second further exchange of hostages and prisoners after a successful week-long truce at the end of November, is expected to last until Friday. The number of Palestinian prisoners that Hamas would release in exchange for the Israelis it holds in Gaza remains the main sticking point in the talks, according to the Israeli media site Walla, citing unnamed US and Israeli officials. The report said Egypt and Qatar were attempting to get Hamas to reconsider its position, the outlet added. “As of now we have freed 112 of our hostages in a combination of strong military pressure and tough negotiations,” Netanyahu said in a statement late on Wednesday “This is also the key to freeing more of our hostages … I insist that Hamas drop its delusional demands. When they do so, we will be able to move forward.” Later, the prime minister declared on his Telegram account: “We will fight until complete victory and this includes a powerful action in Rafah as well, after we allow the civilian population to leave the battle zones.” It was unclear from the statement where those trapped in Gaza were supposed to go. Most of the Gaza Strip has been devastated by bombing and is unfit for habitation. The International Committee of the Red Cross said: “If war plans foresee the evacuation of the population in advance of such hostilities, it is critical that they account for the reality of massive numbers of people moving across bomb-damaged roads, past the rubble of destroyed buildings and through areas contaminated by unexploded weapons. “Evacuations have to ensure that civilians arrive safely, and have satisfactory conditions of hygiene, health, safety and nutrition, and that members of the same family are not separated.” On Wednesday, on Israel’s other wartime border, a rocket attack on northern Israel from Lebanon reportedly killed one person and injured seven, leading Israel to carry out retaliatory airstrikes that killed four people including two children. The Lebanese militant group Hezbollah and Israel have traded fire almost daily since the war in Gaza broke out, although the Iran-backed militia did not immediately claim responsibility for Wednesday’s rocket attack. Across the region there is a palpable fear that time is running out to broker a truce that would bring much-needed relief to the besieged territory’s 2.3 million people, return the estimated 130 Israeli hostages still in Hamas captivity to their loved ones, and prevent the war from escalating into a wider conflict. In an unusual intervention, the West Bank-based Palestinian Authority president, Mahmoud Abbas, on Wednesday urged Hamas to agree to a deal quickly to avoid “dire consequences”. “We call on the Hamas movement to quickly complete a prisoner deal, to spare our Palestinian people from the calamity of another catastrophic event with dire consequences, no less dangerous than the Nakba of 1948,” the 88-year-old autocratic leader said, referring to the mass expulsion of Palestinians from their homes after the creation of Israel in 1948. Conditions in Gaza are already catastrophic. Israel’s war on the small coastal territory, now in its fifth month, was sparked by Hamas’s unprecedented offensive of 7 October last year, in which about 1,140 people were killed and another 250 were abducted as bargaining chips. The Israeli offensive has killed more than 28,000 people, displaced more than 85% of the population and reduced more than half of Gaza’s infrastructure to rubble. According to the UN, 10% of children under five are now showing signs of acute malnutrition. Food deliveries and other aid that reaches the strip are regularly mobbed by desperate people or seized by Hamas or organised crime groups, residents say. Cairo has expressed alarm that an Israeli push into Rafah could force Palestinians to flee into the Sinai. There is also widespread concern among Arab governments, especially Jordan, that an offensive on Rafah spilling in to the holy month of Ramadan could spark explosive unrest on the West Bank. The health ministry in Hamas-controlled Gaza said about 100 people had been killed in Israeli airstrikes and shelling in Rafah and Khan Younis, just to the north, over the past 24 hours. In Khan Younis, fierce street fighting has continued, driving Palestinians sheltering at the main hospital to begin leaving. Residents said sniper fire at Nasser hospital had killed and wounded many people in recent days. The Israel Defense Forces (IDF) said in a statement: “The IDF will continue to operate in accordance with international law against Hamas – which cynically embeds itself within hospitals and civilian infrastructure – and will continue to operate to distinguish between the civilian population and Hamas terrorists.” In a post on Instagram showing a steady stream of people leaving the medical complex on Wednesday, Dr Khaled al-Serr, a surgeon at Nasser, said: “I am writing this with tears and disappointment … My heart is broken, I did not feel [this] sadness when the Israeli army bombed my house. You can read one question in these faces … Where should we go?” It is widely believed that Netanyahu is slow-walking the ceasefire talks and talking up a Rafah offensive because he is likely to be ousted from office in new elections when the war ends. The longtime leader faces several ongoing corruption trials. Israel’s rejection of last week’s counterproposal for a ceasefire from Hamas appears to have further soured relations between Netanyahu and Washington. The US has provided crucial military supplies and diplomatic cover for Israel’s war but, Joe Biden appears to have lost patience over the colossal death toll in Gaza. The relatives of the remaining Israeli hostages have also implored their government to do more to free their loved ones. “Time is running out … Every day spent waiting means more hostages will die. Hostage families call on Netanyahu not to alienate his American allies and return to the negotiating table to implement a deal, the only viable path towards releasing all the hostages,” a statement from the families forum said. On Wednesday dozens of freed former captives and family members also visited the international criminal court in The Hague, where they urged prosecutors to charge and seek the arrest of leaders of the militant group.