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targeting a safe house and training facilities used by iranian affiliated groups. that's according to the pentagon. we've got the latest on the significant escalation in the middle east amid rising tensions. plus, on defense, donald trump jr. back on the stand, the first witness for the defense in the new york civil fraud trial calling his dad today a visionary. what impact will his testimony have. and could the qanon shamon go back to washington, after serving 27 months behind bars, he's filing paperwork to run for congress. our nbc news reporters are following all of the latest developments. i want to begin in gaza with one doctor in al-shifa hospital saying 600 patients need care, there isn't food and water among other things needed. erin mclaughlin is in tel aviv. you talked to a doctor inside al-shifa this morning. what did he tell you. >> reporter: that's right, chris. as the israeli military has pushed further and further into gaza city, there's desperation at a number of hospitals including the main hospital al-shifa hospital. i was speaking to the head of neurosurgery inside the hospital earlier today, and he was just describing complete desperation. he said he was talking to me on his phone with what little battery power he had left. for four days now, no one has been allowed to leave the hospital, and no one can get in, and that includes critical aid, food, water, medicine, and critically, fuel. he said the patients are dying at a much higher rate, including at least three prematurely born babies. three dozen more babies that had to be taken from an incubator, he said, could die in just a matter of days. and he's appealing to the international community for help. take a listen. >> the concentration is extremely difficult and dangerous. you cannot even imagine. now without water, without communication. >> reporter: how are you personally coping with this? >> collapsing, you know. i'm not sure how much -- how many days more we will be able to survive, you know. >> reporter: and i was just on the phone with a spokesperson for the icrc about that plea for evacuation, and she told me given the intense fighting that is surrounding any number of these hospitals. there's very little the icrc can do except to remind the israeli military and all parties involved of their obligation under international law. she said that it was heartbreaking to get these calls from doctors, from civilians, pleading to be evacuated. and again, just very little that they can do. now, in terms of the israeli military, they say they dropped off 300 liters of fuel outside the main entrance of al-shifa hospital yesterday. they say that hamas is preventing the hospital from picking up that fuel. hospital officials tell us that that fuel is simply a drop in the bucket. that they need 10,000 liters a day just to run the hospital for one day, chris. >> erin mclaughlin, thank you for that. the pentagon is announcing it's carried out two air strikes in syria. this marks the third retaliatory strike in recent weeks. nbc's courtney kube has more for us. what's the latest? >> reporter: the u.s. military carried out another set of air strikes in northeastern syria. this is the third recent set of air strikes the u.s. has taken there, all with the goal of deterring these attacks against bases with americans in iraq and syria. in fact, today wknow there have been at least 52 attacks against bases. that includes four since the u.s. carried out these air strikes just last night. now, the target is a little bit different this time from the two previous strikes. those were weans and ammunition facilities. now, in this case, there were two locations, one was a training facility and the other was a safe house. because of that, there is a possibility that some of these iranian-backed militia members may have been present at either site at the time of the strike according to u.s. officials. now, it's very different than the previous two. the u.s. generally takes these kinds of strikes in the middle of the night to minimize the chance of people being present, but just given the nature of these locations, it is possible we will hear about potential casualties on site. now, again, this is all to try to deter against these attacks against bases in iraq and syria. more than 50 of them now at least 56 u.s. personnel have suffered minor injuries because of these attacks, and the u.s. is extremely concerned that if these sorts of attacks with one-way drones and rockets and indirect fire, if they continue that we could see u.s. casualties and that that could spread to a larger conflict in the region. the u.s. is very clearly saying that these strikes are to call on these militia groups to stop attacking their bases, but even beyond that, u.s. officials here in the pentagon, calling on iran to direct those militia groups to stop carrying out these attacks. of course, iran funds, trains, and equips many of the groups that carry out these sorts of attacks, chris. >> courtney kube, thank you for that. now to trump's civil fraud trial in new york where donald trump jr. is set to get back on the stand at any moment now, following an hour-long lunch break. nbc's vaughn hillyard is outside the courthouse for us. what are we expecting from the defense as it resumes its questioning? >> reporter: chris, courtroom staff is currently reentering this courtroom after this lunch break. we expect don jr. to go back and take the stand again just before the break began. letitia james, the new york attorney general who sat there for nearly three hours of testimony from donald trump's son picked up her jacket and walked out. for donald trump jr., he is the first witness brought forward by the defense. of course, he has already testified in this case, under a line of questioning from the prosecutors for the new york attorney general's office. over the course of his three-hour testimony, he has run through the litany of properties that he and his family hailed success stories, making the case to the judge who is the one determining the penalties incurred by don jr. as well as the trump organization making case that this is an international corporation that has run successful businesses and to the extent that he was signing off on financial records, he relied on the word of not only the trump organization's own accountants but also outside firms. for don jr., this is the beginning of the defense's building of his case that is expected to last all the way up to december 15th. ultimately we could see other witnesses like eric trump return to the stand, even donald trump himself, chris. >> vaughn hillyard, thank you. the january 6th attacker known as the qanon shamon is trying to take the notoriety of his conviction all the way into the halls of congress. he's running for office in arizona. ryan reilly has latest reporting on this. tell us what's on with this. >> reporter: qanon shamon is a failed actor, big on media attention. he's trying to pivot into running for congress, returning to the place where he committed his crime on january 6th. he ultimate was in the senate chamber and now looking to go to the house, apparently. so it's remarkable to look at these videos of what happened on january 6th, and of course you saw some of this afterwards get sucked into a conspiracy theory about what qanon shaman did, and what jacob did. from the beginning, you can see on the videos him entering the building right behind this initial breach of the mob, and then taking the dais that belonged to former vice president pence and leaving a threatening note for him. so he was one of the first people to go to trial or rather to take a plea deal and be sentenced and ultimately got a sentence that has let him out to run again in 2024. a remarkable turn of events. it remains to be seen whether he's going to pick up traction or if this is a media stunt that he has done throughout the years. >> it is where we are in this world, ryan reilly, thank you. a major escalation today in the 2024 race for the white house with the two front runners running on totally different tracks. we're back in 60 seconds. blanco there are some things that go better... together. hey! like your workplace benefits... and retirement savings. with voya, considering all your financial choices together... can help you be better prepared for unexpected events. for a brighter financial future. thanks. ahh, pretzel and mustard... another great combo. voya. well planned. well invested. well protected. . the 2024 race for president is escalating as the front runners, president biden and former president trump's campaigns, though, could not be more different. here's the message from donald trump over veterans day weekend. >> in honor of our great veterans on veterans day, we pledge to you that we will root out the communist, marxist, radicalist left thugs that live like verman in our country. >> used by hitler and mussolini to dehumanize peoplend encourage followers to engage in violence. for trump's spokesperson who make that ridiculous exertion, their sad miserable existence will be crushed when trump returns to the white house. meantime, president biden visited arlington national cemetery to mark veterans day and his campaign put out a more traditional political ad. >> he's a war hero. he's a war hero because he was captured. i like people that weren't captured, okay, i hate to tell you. >> joining us now, sam stein, "politico" white house editor and msnbc contributor. tim miller is former communications director for jeb bush's campaign. writer at the bulwark and msnbc political analyst. sa ben's calai is hitting trump over his vermin remark. on weekend when most americans were honoring our nation's heroes, donald trumparted the language of adolf tl, and benito mussolini, in order to defeat exactly the kind of un-american ideas trump champions. the candidates are dug in. we know where their sides are, but will something like this resonate with that small number of voters who will decide this election? does team biden think it will? >> i think ultimately, yes, but we're a year out from the election, and so this will probably be memory hold, like many of trump's remarks in a similar vein. look, does this help trump? no. i think if he were to stop with this rhetoric, i don't know if he can stop with the rhetoric, but certainly it would do more to endear him to those republican voters, those independent-minded voters that fundamentally have real problems with him and probably won't vote for him because of comments like these and his record in office. does biden do enough to win them over is the real question, right? biden has a lot of ground to make up in terms of getting voters back into his camp. most of the meetings happening among younger, progressive minded voters, but certainly some independent, moderate lane who gave him a chance, may not do it again. to your point, chris, yeah, these don't help trump. i think they're going to matter more if he continues doing them closer to voting day. >> our good friend kristen welker asked on "meet the press," rnc chair ronna mcdaniels, what she thought about the comments. >> are you comfortable with the language from the gop front runner? >> again i'm not going to comment on candidates and their campaign messaging. >> i mean, look, the lack of a rebuke from ron na mcdaniel is no shock. there's an ongoing rolling narrative. "axios" reporting today, trump's allies are prescreening thousands of potential foot soldiers as part of an operation to expand his power at every level of the government, if he wins in 2024. is there a cumulative effect that the biden camp can use or is this just more reason for his supporters to love donald trump? >> yeah, well, first on the vermin thing, i mean, what ronna mcdaniel said is not true. she was making fun of vivek's poll numbers two minutes earlier. what she meant to say is i can't criticize what donald trump says because he's my boss. i agree with sam. people know what they're getting from donald trump with these kinds of remarks. they should be covered. there should be outrage. the republicans intended like they were offended by the deplorables comment that hillary clinton made. obviously we can see now that was crocodile tears. they should be treated the same. i think that "axios" report you're discussing is more important, both electorally, and substantively, though, than trump's gaffes, and some of this is new information for voters, right, like trump being a clown who says crazy things is not new information. trump planning, you know, to target political foes, deportation camps, you know, some of the stuff people think about but have it be explicit in writing. he's planning camps for immigrants. >> that reporting from the "new york times" was very detailed and eye opening. >> yes, i think that information is new information for voters that might affect his political standing and obviously substantively, it's deeply alarming and important. >> there is one thing we know, sam, that voters on both sides have paid a lot of attention to, and that's something that neither of them can change, that is their age. forbes reports trump has confused biden and obama seven times in just recent months, including this weekend. >> the head of hungary, a very tough, strong guy, viktor orban, did anybody ever hear of him, they were interviewing him two weeks ago, and they said, what would you advise president obama, the whole world seems to be exploding and imploding, it's simple, he should immediately resign, and replace him with president obama. >> at a past rally, he called viktor orban, the leader of turkey. many democrats do see an opportunity here to challenge trump's mental acuity. could that work or does it just reinforce the whole narrative or reminding people that these guys are older? i'm not going to say old because i'm not exactly that far away from it, but older. >> chris, what are you talking about, you got to be, what, 35. >> i think that's what's happening here is, yes, they are older, and yes, they're both trying to figure out a way to cleverly use this against one another. and biden, for his part, has in recent days, and you've seen it here and there, leaned into it with more humor. he's joked about tripping. he made fun of the press for focusing on these issues. but his campaign apparatus has been really hard on trump for these moments as well. they have gone after trump for these -- for just misspeaking by saying it's president obama in office. they clearly want to neutralize the impact against joe biden. and trump, you know, it's been very interesting to watch him. if you watch his speech, usually he'll say something akin to, you know, 80 is not that old. i have plenty of friends and colleagues in the business community that are over 80 and they do just fine. they're wizards. what really matters, trump says, is your mental acuity, and biden doesn't have that. he's nuancing the age and stamina question too. it just really is like a deeply depressing insight or foreshadowing, i should say, into how this next year is going to go between these two men as each of them and their candidates try to frame the other one as the more elderly and feeble individual. >> sam stein, something for all of us to look forward to. tim miller, you're going to stick with me. breaking news, former president donald trump's older sister, mary anne trump barry has died. she served as a federal appellate judge in philadelphia, at a time when investigations into the trump family's tax practices began to heat up. former president trump has not yet commented on his sister's death. she was 86 years old. new developments, why the feds are now investigating new york city mayor's text messages. but first, they vowed to do it for the city, and they did. the lewiston, maine, boys high school soccer team just won the state title, near weeks after the deadliest mass shooting that state has ever seen, 18 people killed there. the blue devils beat the rtland rams 3-2 on saturday. lewiston's goalie said it feels great to win for the city and bring some good to the city. bravo to the team. we'll be right back. 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>> i mean, i haven't had a chance to read through it. the politicalization of the supreme court is much bigger than just the ethics, the supreme court nominations have become life and death baths with rights hanging in the balance. i don't see that changing anytime soon. in addition to that, the issues, the ethical issues that clarence thomas and others have exhibited has been over the top. you have to remember ginni thomas's active complicity with donald trump and mark meadows back on january 6th. i think the democrats have to do something on this, and no matter what is in the guidance and you look at the house and how republicans have been running sham oversights, the democrats have a serious issue here, they should be doing oversight. whether it's legislation, i think there should be more oversight on what's happening, particularly in the case of thomas. >> tim miller, thank you so much. i appreciate you coming in, having that for us with really moments to spare. we also have another big story that's developing out of new york city, the fbi looking at mayor eric adams' test messages to the fdny onf of the turkish government. adams hasot been charged out with wrongoing and yesterday released a statement saying quote, i have not been accused of wrong doing, and i will continue to cooperate with investigators. nbc investigations correspondent tom winter is following this story. so what do we know about this investigation, tom? >> well, chris, not a whole heck of a lot because it appears to be wider and broader than we're aware of, and we're tracking down a number of leads in reporting this story out, including the one you referenced with our colleagues, melissa rousseau and jonathan yates. heers here's what we have been able to confirm so far, one is to the point that you referenced the messages to the then fdny commissioner, daniel nigro ask if heck look into a building safety issue with the new consulate located near the u.n. on first avenue and so that in and of itself would not be something that's illegal. otherwise, every politician in new york and any mover and shaker in new york city would be in jail. this is the type of typical constituent advocacy that goes on all the time, and certainly not any indication of wrong doing by the former fdny commissioner. the question is whether or not, and it's where we believe the investigation is, whether or not adams received any sort of renumeration or any sort of specific benefit for taking this specific action. that's something that individuals have been charged with in the past. and that's something that the fbi does typically investigate. to that end, we do know from our reporting that last week a phone and an ipad belonging to the mayor of the city of new york was seized by federal agents. obviously there's a bit of a hurdle they have to overcome there. they have to file an affidavit and swear to it in front of the judge at the court that contains a number of information and pieces of information that they have gathered to try to convince a judge that there is probable cause, that there is evidence pursuant to a federal criminal investigation that might be contained on those devices. huge caveat in all of this, and you mentioned the mayor hasn't been charged with wrong doing. it's not a guarantee when someone is subject to a search warrant. i think back to the rudy giuliani investigation, his home was searched, his devices were searched and he did not face any charges there. i think there's a lot of this we haven't been able to uncover ourselves in the course of our reporting. this is obviously a very active investigation, so we'll just have to see where this goes in the days, weeks and months ahead. >> tom winter, thank you so much. still to come, the new and deeply disturbing threat of fentanyl poisoning kids, younger than you might realize. >> it was a life and death situation. >> this is texas to tennessee, baltimore to los angeles, no one is spared. is spared. oh, hello! hi! do you know that every load of laundry could be worth as much as $300? 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>> we think it's a combination. so we don't actually know the answer to that, chris, with clarity. probably a combination of the fact that somebody's losing weight. we know that being overweight or obese is a big risk factor for heart disease and diabetes and high cholesterol. losing weight in and of itself, a big deal. critically and to your point, we think this medication reduces levels of inflammation in your body. inflammation is what predisposes to plaque build up in the arteries around our heart and can cause a heart attack. it's likely multifactorial. i will say for the type ii diabetics on insulin, something we don't talk a lot about. insulin type 2 diabetes, we're seeing 16 weeks on therapies can release insulin needs from going from a state where you have high insulin needs and not needing insulin at all. that was an extraordinary finding. >> an extraordinary benefit. i wonder if there's a chance, then, that this study could help convince insurance companies to expand drugs like wegovy. >> i'm glad you brought that up. that is the key piece here is access. i cannot tell you how many times i have heard from close friends, from patients, this sound amazing. i can't get access to it. it's too expensive. medicare, medicaid, do not cover this specific medication because, chris, this is five times the list price of this exact medication is five times higher in the united states than it is in japan. ten times higher than it is in places like sweden and the united kingdom. just a marked up list price than what it is, the exact medication, overseas, that's part of the problem, it's too darn expensive. there's going to be relief, though. these types of studies are going to put pressures on payers and the pharmaceutical companies to lower that price, i hope. and then, two, critically, there's going to be oral versions of the medications that we'll probably see in the next 12 to 18 months. pills are cheaper to produce, cheaper to distribute, so i'm hoping that adds downward pressure on pricing, but make no mistake, the price of these medications is five to ten times higher than what we're seeing in some of our peer countries across the atlantic. that's unacceptable, and frankly putting profits over people. >> dr. vin gupta, thank you. there's a new battle ground in the nation's fight against fentanyl. children as young as middle schoolers are accidentally being poisoned by pills laced with that deadly drug. nbc's morgan chesky reports on how one texas middle school is fighting back. >> sometime after 9:00 he took the pill that took his life. >> alexander nevel died of fentanyl poisoning in 2020. the california teen was 14 years old, just barely out of middle school. >> you feel like a complete failure, we're beating ourselves up over it all the time. >> reporter: his mother amy confessing she didn't even know what fentanyl was. >> death blind sided us. no one was talking about fentanyl at the time. >> reporter: according to amy, her teenage son thought he was taking oxycodone, but a toxicology report later revealed that one natal pill was laced with fentanyl. >> it was a life or death situation and i didn't realize that. >> reporter: a threat that's made its way to cleveland, texas. a sobering show and tell at a middle school. >> ready, that's it. you just saved a life. >> reporter: in a cafeteria where kids eat lunch, parents using how to learn narcan to potentially save their own child from fentanyl poisoning. >> it's incomprehensible. >> reporter: here for her three kids and free narcan. >> at first, i was like, no, let's not have this. it's going to give a gateway for these children to go ahead and say, hey, there's something to save me. let's just try it anyway. >> reporter: and now? >> we need it. >> reporter: because parents here are facing something they have never seen before, explosion of opioid related incidents. barely three months into the school year, the district's reported 15 emt calls, eight overdoses, none fatal, but four needing narcan, and an arrest at one of the middle schools for possession of opioids. >> if anything were to happen to one of these students, our district would feel it. >> reporter: with two high schoolers of her own, fight is personal for nurse director lacy green, who rebuilt campus first aid kits. >> if it's a situation they need to give narcan in, they have it on them. >> reporter: at every campus in the district, even at the elementary schools. junior leslie gonzalez, and senior, say the difference from last year to now, dramatic, not just in overdose but access to drugs like percocet, often unknowingly laced with the fatal drug. >> how easy are these drugs to come by? >> very easy. >> reporter: how easy? >> to the point where you could look at someone in the class and you could ask and they would have it. >> reporter: texas has seen fentanyl deaths raise 600% in three years, 2/3 of those deaths in those 18 and under. >> what's happened with the pandemic and youth is a skyrocketing, national epidemic of crushing anxiety that makes these kids not want to come to school. >> reporter: which is wa what drives dr. joy alonzo to come to towns. >> texas to los angeles, no one is spared. >> it's hard because i want my kid. >> reporter: a painful reality, one amy neville wishes she could rewind every single day. >> a little bit of information could have gone a long way in our house that night. we didn't have that, and we paid the price. >> morgan chesky, nbc news, cleveland, texas. >> what a brave mom to share that. what a wake up call. still to come, president biden's new comments on the israeli-hamas war. he made them just moments ago. we'll have the details next. t. with thyroid eye disease i hid from the camera. and i wanted to hide from the world. for years, i thought my t.e.d. was beyond help... but then i asked my doctor about tepezza. (vo) tepezza is the only medicine that treats t.e.d. at the source not just the symptoms. in a clinical study more than 8 out of 10 patients taking tepezza had less eye bulging. tepezza is an infusion and may cause infusion reactions. tell your doctor right away if you experience high blood pressure, fast heartbeat, shortness of breath or muscle pain. before treatment, tell your doctor if you have diabetes, ibd, or are pregnant, or planning to become pregnant. tepezza may raise blood sugar and may worsen ibd. tepezza may cause severe hearing problems which may be permanent. test test test test test test ts after photos. hi, my name is damion clark. if you have both medicare and medicaid, i have some really encouraging news that you'll definitely want to hear. depending on the plans available in your area, you may be eligible to get extra benefits with a humana medicare advantage dual-eligible special needs plan. all of these plans include a healthy options allowance, a monthly allowance to help pay for eligible groceries, utilities, rent, and over-the-counter items. the healthy options allowance is loaded onto a prepaid card each month. and whatever you don't spend, carries over from each month. other benefits on these plans include free rides to and from your medical appointments. and our large networks of doctors, hospitals and pharmacies. so, call the number on your screen now and ask about a humana medicare advantage dual-eligible special needs plan. humana. a more human way to healthcare. . we just got tape in from moments ago. this is from a signing ceremony in the oval office. president biden taking questions from reporters about the government shutdown, the israel-hamas war, and more. here it is. >> prior to a potential shutdown, i understand that the new speaker of the house has a proposal. it's being negotiated with minority leader of the house and senator schumer, and the republican leader are also talking about it. i don't know what the outcome is going to be. apparently there's a meeting today at 4:00 or 5:00 on the rules committee. and we'll see what happens. >> reporter: would you detail the cr? >> i'm not going to make a judgment on what i would veto or sign. let's wait and see what they come up with. >> reporter: have you heard about the hospitals in gaza, sir, any precautions on the hospitals in gaza? >> the hospital in gaza, have you expressed specific concerns to israel on that, sir? >> well, you know, i have not been reluctant in expressing my surgeon of what's going on. it's my hope and expectation that there will be less intrusive action relative to the hospital. and with the israelis. also, there's an effort to take this pause to deal with the release of prisoners, and that's being negotiated as well. the qataris are engaged and i remain somewhat hospital. but the hospital must be protected. >> thanks, guys. >> i want to bring in former "washington post" jerusalem bureau chief, janine zakaria. kelly o'donnell, our reporter there, trying to get to the president about what the headline making news and photographs have been over the last 24 hours or so, particularly 36 premature babies whose lives are on the line. the main hospital inside gaza, basically, according to the world health organization, not functioning anymore. so he says, you know, that the hospitals must be protected. how narrow is the tight rope president biden is walking right now, support for israel versus the growing concern for civilian deaths? >> well, he was pretty explicit in saying he wants to see, the words were less intrusive action regarding the hospital. the issue is that you have hamas fighters at al-shifa hospital and at al-kutz hospital, you saw hamas fighter with an rpg operating right from the chance there, and we know that there is this vast labyrinth of tunnels that hamas has constructed beneath the hospitals. the question is how does israel balance military necessity here against civilian harm, and so i think that the prime minister netanyahu is listening very carefully to the words that president biden uses and whether that has an impact on how fierce the battles are around the hospital, i'm not sure. i think one thing that the international community can be doing here is looking at ways to more effectively evacuate people from that area during any humanitarian pause that may be forthcoming, and also more forcefully be saying something like, you know, you hear a lot of chants of free palestine, but free palestine from hamas. i mean, they are the main problem there that is causing this. so i think there hasn't been a lot of an articulation of that. so, you know, this has become -- this is not only an israeli problem. the united states has been dragged into this now, too. this is something that former u.s. ambassador to israel, i was looking back at an op-ed from 2024, first when israel was first talking with president bush about pulling out of the gaza strip, and he said it's going to be the u.s.'s problem if this becomes a failed terror state after the israeli withdrawal, and pretty much this is what we're living with, the consequences of that. >> you know, we have been seeing these protests all around the world, thousands of people, in some cases, tens of thousands of people calling for more to be done to protect civilians in gaza, whether it's president biden or benjamin netanyahu. to what extent do you think this type of public pressure is coming to bear and maybe will influence the ultimate outcome? >> i mean, look, ultimately the israelis, there's always sort of a dance here that happens in these situations in terms of how much leash does the u.s. give israel. i hate to use that kind of analogy in such a serious situation, but israel is showing no sign of stopping now that they're making progress in sort of rooting out and destroying some of the tunnels, they don't want to stop right now, so i think the one thing that could lead to some sort of a stoppage is if they they could get the hostages released. i mean, chris, i don't even think the international committee for the red cross has seen most of these 240 hostages, including children that are being held. so i think if the international community could somehow get that moving and get some access to these people and ultimately get them released as soon as possible, the israelis might be amenable to some kind of a pause. i don't think a cease fire. a cease fire would mean from the israeli perspective that hamas remains the rulers of gaza, and that is not something that israel is going to be able to live with after the massacres of october 7th. thank you, we appreciate it. we want to go to the white house briefing room where the national security adviser jake sullivan is talking about conversations between the u.s. and israel. let's listen. >> among the civilian population in gaza. we're glad to see israel take an important step in this direction last week and we remain in active discussions with the israeli government about the importance of the tactical humanitarian pauses in the fighting to permit civilians to depart areas of active hostilities to increase the flow of aid and enable hostage releases. we continue to have discussions at all levels, including president biden with prime minister netanyahu to urge israel to continue taking every possible measure to protect civilians. the loss of every single life is a tragedy. whether a palestinian civilian, an israeli civilian or anyone else, and we grieve for every innocent who is lost. at the same time, we will continue to stand behind the proposition that israel has the right to defend itself against terrorist attacks. with hamas, you are dealing with an organization that's come out publicly since october 7th and said that it intends to commit another october 7th, until israel no longer exists. you have a leading spokesperson saying the objective is a permanent state of war with israel. that is the reality that israel is confronting, and a reality that would be unacceptable for any nation, and with that, i will be happy to take your questions. >> thanks, jake. you said yesterday and the president said just now in the oval office that hospitals, in gaza need to be protected. do you believe that the israelis have received that message, and have they had any response. >> first, what the president has just said, and i said is we do not want to see fire fights in hospitals, we want to see patients protected, and hospitals protected. we have spoken with the israeli government about this, and they have said they share that view. they do not want to see fire fights in hospitals. you heard from idf spokes people, stating things along those lines. the israeli government have told us they are prepared to provide fuel to hospitals to ensure that they can continue to operate, and that for certain hospitals, they actually have not been able to be in communication with the people who are actually running the hospitals. that's something we will continue to work on. the position of the united states on this matter is clear. hospitals should be protected. hospitals should be able to run effectively so that medical care can be given to patients, and finally, to the extent people need to be evacuated from one hospital to another hospital in order to ensure the continuation of care, evacuate routes have to be safe, and the israeli government has told us as recently as today that there are and will continue to be evacuation routes for people leaving hospital compounds. so these are positions that for us are straightforward, they are clear, we have a constructive discussion with the israeli government on this and i believe that they have indicated they hold similar positions on these issues. now, as for what happens on the ground, you know, in a given hour, on a given day, we can't react to every individual report. we can simply continue to state our position, and continue to consult with the israeli government to ensure that they are doing their best to fulfill their stated position on this. >> and more broadly, the u.s. is now focused on two wars, one in the middle east, one in ukraine, what would it mean for this government and in particular, foreign policy and the military if there were to be a government shutdown come friday night? >> this would be a devastating blow. first of all, to our service members at a very human level. it would have an impact on the ability of our troops to -- and their families to get all of the benefits and services they need for the service they are performing for our country. second, it would send a signal to the world that the united states cannot pull together on a bipartisan basis to sustain government funding and to show united face to the world at a moment where you see the turbulence around the world. we will do everything in our power to support congress coming together around a measure that will fund the government and not have a shutdown occur at the end of this week. >> there's an effort to use the pause to deal with the release of prisoner that is being negotiated with qatar. could you amplify on that? >> there have been ongoing talks with the nation of qatar. president biden spoke by telephone. the united states has been talking to israel and qatar in an effort to try to move forward these negotiations to a point where hostages can be released and reunited with their families. we're not there yet, but we're continuing to try to make progress on that day by day, hour by hour, and as i said before, the president has no higher priority, which is why he's personally engaged on the issue. >> what does the president plan to tell president xi in terms of getting iran to reign in his proxy attacks on u.s. forces in the middle east? >> from our perspective, the prc should share the interest of every responsible country. deescalation, rather than escalation should be the order of the day. president biden will make the point to president xi that iran asking in an escalatory, destabilizing way, that undermines stability across the broader middle east is not in the interests of the prc or any other responsible country, and the prc of course has a relationship with iran, and it's capable, if it chooses to, of making points directly to the iranian government. >> israeli intelligence, does the u.s. have independent intelligence that hamas has military facilities to bunker under the al-shifa hospital in gaza? >> what i said yesterday is i'm not in a position to comment on intelligence matters. american intelligence matters, i can't divulge that to you. what i can tell you is we see plenty of open source reporting about hamas's use of hospitals and other civilian infrastructure to store weapons, house fighters, to engage in forms of command and control. beyond that, i'm not in a position to speak specifically to a report about a specific hospital or specific bunker. >> and so when the president says that hospitals must be protected, what does the president, what does the united states want to see done with al-shifa hospital in particular and open source intelligence? >> your question points up the complexity of this complex and the added burden that israel is facing as it goes against murderous terrorists who continue to say their goal is the absolute destruction of the state of israel. you're dealing with a terrorist organization, hamas, that takes civilian hostages, including little children that uses

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