After weeks of declining to back growing international calls for “humanitarian pauses” in Israeli airstrikes to allow a steady flow of aid to enter Gaza, permit American and foreign citizens to exit into Egypt and facilitate the release of hostages, the Biden administration is now fully in favor of them and is pressing Israel to agree. The abrupt policy shift comes as the humanitarian situation inside the enclave has become more dire and much of the world has declined to follow the U.S. lead in withholding public criticism of how Israel is conducting its war against Hamas.

David Satterfield, President Biden’s special envoy to the humanitarian situation in Gaza, has been in Israel this week seeking progress on both aid and egress to Egypt. But according to U.S., United Nations, Egyptian and Israeli officials, many of whom spoke only on the condition of anonymity amid a welter of finger-pointing among those involved, no substantive progress has been made.

The administration’s public promotion this week of humanitarian pauses came after what one U.S. official said was “a lot of the groundwork in private communications.” But it still left the United States behind the curve of international opinion, as the U.N. General Assembly on Friday overwhelmingly approved an Arab-sponsored resolution calling for a complete cease-fire. Only 14 of the 193 U.N. member nations voted against the measure, including the United States, Israel and several Pacific island and eastern European states. Most close U.S. allies were in favor or abstained from the vote.

The resolution called on “all parties” to comply with international law in the conflict and specifically demanded rescission by Israel, “the occupying power,” of evacuation orders in Gaza. It did not mention Hamas by name or refer directly to its Oct. 7 attack on Israel. Last week, the United States vetoed a U.N. Security Council resolution calling for humanitarian pauses, saying that the measure did not affirm Israel’s right to defend itself. Over the weekend, Secretary of State Antony Blinken offered to “consider” such pauses to protect civilians. On Tuesday, as the Gaza death toll rose, the United States introduced its own resolution calling directly for humanitarian pauses.

“We absolutely believe that if a pause can be effected to allow for the release of hostages, that is something we absolutely support. We believe Israel would support it,” National Security Council spokesman John Kirby said Friday. The administration would also “support humanitarian pauses for stuff getting in as well as for getting people out” of Gaza. But, he said, he had “no news to report.” Negotiations are ongoing over what Israel would get in exchange for a pause. Hamas has said it was willing to release all non-Israeli hostages in exchange for a limited cease-fire, including citizens of 41 nations among about 200 captives, although both the United States and Israel are dubious. It also said it would consider freeing Israeli civilian hostages if its other demands are met, including the freeing of thousands of Palestinian prisoners in Israel.

Four people, including two U.S. and two Israeli civilians have been released so far following negotiations brokered primarily by Qatar. Despite persistent reports that a larger hostage release was imminent, involving dozens of people, there was no sign Friday of any breakthroughs.

At the same time, no one, including at least 400 American citizens and their families, has been able to exit Gaza since the border closed shortly after the war started. Egypt says that its side of the crossing is open, but that Palestinians can’t cross safely because Israel refuses to stop its airstrikes. Egypt also fears a rush of non-foreign Gazan refugees into its territory.

A senior Egyptian official said Tuesday that Egypt was “ready to receive” the foreign passport-holders from Gaza, but “the Israelis are threatening the Palestinian side” and “Palestinians who work there don’t feel safe” because of ongoing Israeli strikes. “We are saying that the Israeli side should do the responsible thing for the foreign nationals in Gaza and allow them” to leave, meaning “do not attack authorities or areas they need to be in to be able to go out,” Diaa Rashwan, chairman of the State Information Service said. He indicated that Israel does not distinguish between militants and civil servants in the Hamas-controlled government who regularly man the border and have not been showing up at work for fear of Israeli attacks.

Israel and the United States have blamed Hamas, which controls the Gaza government, for blocking the gates on the Gaza side. Echoing weekend comments by Blinken, Kirby said “the main holdup here is Hamas.” Of the many civilians The Washington Post has contacted inside Gaza waiting to leave, none has said that Hamas or anyone else has physically prevented them from crossing. But the border gate is not operational.

Zakaria Alarayshi, 62, who runs a welding business in Livonia, Mich., traveled to Gaza with his wife, Laila, 58, to visit family.

Among the many trapped by the war, they’re staying at the home of a stranger who offered to take them in after the couple tried - and failed - to exit via Rafah. A diabetic with high blood pressure who estimated he has about three days of medication left, Alarayshi said he can’t sleep at night because of the sound of the bombings. “The situation is so bad,” he said, “We’re scared all the time.” The State Department has repeatedly sent messages to Americans telling them the crossing might open but he and his family have rushed to the border with Egypt only to find the gates closed, Alarayshi said.

Abood Okal and his family, who live in Massachusetts, said he and his wife and 1-year-old son are staying about a 10-minute drive from the crossing, sleeping on the floor of a friend’s home with dozens of others, including about 10 Americans. The airstrikes are intensifying, he said Friday, including one close enough to shatter the windows. On Thursday, another struck a building about 800 feet away. “We’re trying to stay strong,” he said, “but we cannot help but feel hopeless and abandoned.” A person familiar with Israel’s position in discussions over the border situation said that Israel has “no problem with people leaving the Gaza Strip to go to Sinai. “The problem is what is coming in, not what’s going out.” This person said “it’s an Egyptian issue. They are worried that if they open Rafah” to let the foreigners out, “a hundred thousand people will break down the gates.”

Diplomats outside the core of actors involved in the talks said they have little insight into what obstacles remain, even as they try to evacuate their own nationals from Gaza. One diplomat in Cairo said they were “more confused” as time goes on, and “the information flow is all over the place” on the border talks. What looked possible a week or two ago, this diplomat said, has now evolved into a “full blame game.” After the Hamas attack, which left at least 1,400 Israelis dead, Israel imposed a complete siege on the Gaza Strip - cutting off electricity, fuel, water and other critical supplies. As casualties from ongoing Israeli airstrikes have mounted - with more than 7,000 killed, according to the Gaza Health Ministry - and the humanitarian situation has become more urgent, calls for aid to be let in mounted.

A range of countries and the United Nations have together sent hundreds of tons of humanitarian aid to Egypt’s Arish airport near Rafah, where the Egyptian Red Crescent is organizing aid for delivery to Gaza. In recent days, more than 200 trucks filled with aid stood waiting on the Egyptian side of the crossing. Angry truck drivers staged a protest last week, demanding they be allowed to deliver their desperately needed cargo to “Palestinian brothers” on the other side of the border. Part of the initial holdup was reaching an agreement on a procedure that Israel would agree to for inspecting the aid.

Eighty-four truckloads have now entered Gaza from Egypt since last weekend, just a small fraction of the more than 100 a day that U.N. officials have said is the bare minimum for civilian survival. U.S., U.N. and Egyptian officials have said a main impediment to a more substantial flow is the length of time it has taken for Israel’s inspections of every truck at a the separate Nitzana crossing between Egypt and Israel in Sinai, 30 miles south of Rafah.

Inspections that take 10-15 minutes during the normal flow of Egyptian-Israeli trade are now taking “hours,” according to Ahmed Salem, president of the Sinai Foundation for Human Rights, a British-based nonprofit that has a monitoring team in north Sinai. “The verification system for the movement of goods through the Rafah crossing must be adjusted to allow many more trucks to enter Gaza without delay,” U.N. Secretary General António Guterres said in a statement Friday.

The U.S. official said that with agreement to allow even a small amount of aid to flow, “discussions are now about how we can get more in sustainably and at a bigger scale.”

The pace of relief supplies remains far below the needs of Palestinians inside. In one new initiative Friday, a medical team trained in handling war-related injuries arrived in Gaza along with six trucks carrying humanitarian supplies, the International Committee of the Red Cross said. The convoy also included a specialist in weapons contamination, a role includes assessing for unexploded munitions and potential health dangers after attacks. The ICRC called the medical team a “a small dose of relief” to help alleviate “the extreme pressure on Gaza’s doctors and nurses.”

Satterfield said in an interview this week with al-Hurra TV, the U.S. government-owned station broadcasting in the Middle East, that “we are doing everything in our power as the United States, and so are our critical U.N. partners, to work with Israel, to work with Egypt, to ensure the coordination of this assistance does allow for the maximum degree possible to go to Rafah and be moved through Rafah - that’s the objective. We’re not there yet.”

Meanwhile, a growing minority of congressional Democrats - at least 18 - has called for some version of a pause or a cease-fire - “a dirty word,” as one Capitol Hill lobbyist put it - amid international outcry over the plight of Palestinians trapped inside Gaza.

Rep. Cori Bush (D-Mo.) and several other progressive Democrats introduced a resolution Monday calling for a “cease-fire now.” Three other congressional Democrats, Reps. Jamie B. Raskin (D-Md.), Susan Wild (D-Pa.) and Sara Jacobs (D-Calif.) on Thursday released a letter endorsing “a temporary cessation of hostilities.” The three lawmakers, who identified themselves in their letter as “Jewish Members of Congress who have family and loved ones in Israel” condemned Hamas, called for the release of hostages, and said they believed Israel should defend itself, before addressing the “growing and deepening humanitarian crisis in Gaza.”

Civilians in Gaza “cannot survive without access to water, food, medicine, and fuel - and resources cannot get to those who need it without a temporary cessation of hostilities for humanitarian workers to do their jobs safely,” they wrote.

Parker reported from Cairo. Joanna Slater in Williamstown, Mass.; Steve Hendrix in Jerusalem; Kareem Fahim in Beirut; and Abigail Hauslohner in Washington contributed to this report.