President Biden and his aides are using an agreement for a brief halt to hostilities in Gaza to push the Israeli government to take broad measures aimed at lessening the harm to Palestinian civilians, including setting up safe areas, allowing in more medical aid and permitting larger deliveries of fuel, U.S. officials say.

American and Qatari officials are also pushing their Israeli counterparts to consider extending the planned four-day pause in fighting if Hamas pledges to free more hostages beyond the 50 now promised. The agreement, whose details were still under negotiation, has terms for extending the pause.

Israel continues to dismiss calls for a longer-term cease-fire accompanied by political negotiations, despite growing U.S. and international concern about the civilian deaths and humanitarian crisis in Gaza.

The American officials, who say they support Israel’s right to defend itself, expect Prime Minister Benjamin Netanyahu and his war cabinet to continue the military campaign in Gaza that began after the Hamas terrorist attacks nearly seven weeks ago, in which about 1,200 people were killed and 240 others abducted.

Mr. Biden called Mr. Netanyahu on Wednesday to discuss the hostage release agreement, and also spoke with Sheikh Tamim bin Hamad al-Thani, the emir of Qatar, and Abdel Fattah el-Sisi, the president of Egypt, according to White House statements summarizing the calls. U.S. officials had been traveling among those three nations to help forge the hostage agreement.

Mr. Biden discussed with Mr. Netanyahu the pause, “which will allow for surging in much-needed humanitarian assistance into Gaza,” according to the White House summary. Mr. Biden also spoke about the need for “maintaining calm” along the Israel-Lebanon border, where Israel and Hezbollah have been striking at each other, and in the West Bank, where at least 190 Palestinians have been killed in violence since Oct. 7, either in encounters with the Israeli military or extremist Israeli settlers.

In their call, Mr. Biden and the Qatari emir “reiterated the importance of protecting civilian lives, respecting international humanitarian law and increasing and sustaining humanitarian assistance to Palestinians in Gaza,” according to the White House.

The two also talked about setting the conditions for “the establishment of a Palestinian state” — a goal that Mr. Biden says is the best solution to the decades-long Israeli-Palestinian conflict.

American officials say the death toll in Gaza — more than 12,000, about 40 percent of them children, according to the health ministry there — is too high, and has turned many nations against Israel’s tactics and undercut public support for the country in the United States. And the U.S. officials are worried about the Israeli military’s expected offensive in southern Gaza, where many of the enclave’s two million people have sought shelter.

As it pummeled Gaza City in the north, the Israeli government told residents to go to southern Gaza, and many did so. But Israel has continued to carry out airstrikes across the south with large munitions: 1,000- to 2,000-pound bombs.

U.S. officials say they have told their Israeli counterparts that an offensive in the south with high civilian casualties would further isolate Israel in the court of global opinion, including among its Arab neighbors, who have sharply denounced the ongoing violence and called for a long-term cease-fire.

“We have made clear to them, as we have made clear publicly, that we think they should not commence with further activities in the south until they have taken the proper steps to account for the humanitarian needs there,” Matthew Miller, the State Department spokesman, said at a news briefing on Tuesday.

Mr. Miller estimated that several hundred thousand people had moved from northern Gaza to the south, adding: “Before any military offensive begins there, we would want to ensure that those people are properly protected.”

The Biden administration has so far refrained from imposing conditions on military aid to Israel, which is by far the greatest leverage that the U.S. has in that relationship. Israel has asked for more bombs and at least 24,000 assault rifles, which has raised concerns among some American officials since the far-right minister overseeing Israel’s national police, Itamar Ben-Gvir, has been arming civilian militias.

Mr. Biden is also asking Congress to approve a $105 billion package of mainly military aid for Ukraine and Israel — with the latter amounting to $14.3 billion.

American and U.N. officials have begun a push to persuade the Israeli government to allow for the creation of safe areas in the south, which in theory would be entire neighborhoods that have been relatively undamaged by strikes so far and would be safe from attacks, U.S. officials say.

David Satterfield, the U.S. special envoy for humanitarian aid, is in the region and is negotiating with Israeli officials over the safe areas, a U.S. official said, with the hope that the planned four-day halt to the fighting gives the Americans enough of a window to get an agreement.

In anticipation of the deal to release hostages and prisoners, the U.S. Agency for International Development positioned humanitarian aid in Egypt for swift delivery into Gaza for once the fighting pauses. U.S. officials say their top goals include providing fuel that would help generate electricity for Gaza’s hospitals, water desalinization, bakeries and sewage pumping, necessary to prevent cholera outbreaks.

At the request of U.S. Secretary of State Antony J. Blinken, Israel agreed late last week to allow 140,000 liters of fuel into Gaza every two days. Under the hostage release agreement, that amount is supposed to increase to 120,000 liters per day for the duration of the pause. But U.S. officials say that is meager given the enormous need, and they are pressing Israel to allow in a much greater amount.

Under the agreement, Israel is also supposed to allow into Gaza 200 trucks loaded with aid per day during the pause, which would include medical supplies and food, twice as much as what they had been permitting. As with fuel, U.S. officials say they are pushing the Israelis to allow in more. The Israeli cabinet can vote to approve any number.

In an interview with National Public Radio on Wednesday, Brett McGurk, the White House coordinator for the Middle East and North Africa, said the agreement should allow for more transit through multiple border crossings into Gaza that he asserted had been under regular shelling from Hamas.

Mr. McGurk, who had just returned from the Middle East after playing a central role in the hostage negotiations, suggested that the four-day pause might be extended, saying that “you can do more with more time.”

“And the onus for more time right now is on Hamas,” he added. “So if Hamas produces additional hostages — and they have given indications to Qatar and to the Egyptians that they will, they’re prepared to do that — the pause here will continue.”

Martin S. Indyk, a former U.S. ambassador to Israel, said he believes that President Biden remains opposed to a cease-fire, as he has said many times, on the grounds that it would amount to a victory for Hamas.

But, he added, “the dynamic that they’ve put in play here is interesting; it’s not that they expect the pause will turn into a cease-fire” lasting weeks or longer.

“It’s that the structure of the pause is such that if Hamas wants to continue to avoid more Israeli military action, they’re going to have to pay for it in terms of releasing more hostages — but getting more Palestinian prisoners in return,” he said.

In his call with Mr. Sisi on Wednesday, Mr. Biden said he “affirmed that under no circumstances can Gaza remain a sanctuary for Hamas where they can threaten Israel and Palestinians alike and imperil any pathway to a durable peace,” according to the White House summary.

But Mr. Biden also reiterated that “under no circumstances will the United States permit the forced relocation of Palestinians from Gaza or the West Bank, or the besiegement of Gaza, or the redrawing of the borders of Gaza,” the White House summary said.

Some Israeli officials have asked the United States to request that Egypt and other Arab nations take in refugees from Gaza, but Mr. Sisi and other Arab leaders have firmly said no — a message that Mr. Blinken has conveyed to Israel.

Officials in the region expect intensive diplomacy to continue, with potential visits in the near future by Mr. Blinken and other senior U.S. officials. In a statement late Tuesday, Mr. Blinken thanked Egypt and Qatar for the roles they played in the hostage deal.

The deal was the fruit of seeds planted in a meeting Mr. Blinken had with Qatari leaders in Doha on Oct. 13, when those leaders told Mr. Blinken that Hamas, which has a political office in Qatar, was willing free some hostages for a pause in hostilities, a U.S. official said.

“While this deal marks significant progress, we will not rest as long as Hamas continues to hold hostages in Gaza,” Mr. Blinken said Tuesday in a statement. “My highest priority is the safety and security of Americans overseas, and we will continue our efforts to secure the release of every hostage and their swift reunification with their families.”

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