The number of Gaza Strip residents reported killed during Israel’s 10-week-old war in the territory has already surpassed the toll for any other Arab conflict with Israel in more than 40 years and perhaps any since Israel’s founding in 1948.

The Gaza Health Ministry said Thursday that the death toll was more than 20,000, putting it above one of the most authoritative estimates of those killed in Lebanon by Israel’s 1982 invasion.

And though Gaza officials have said counting the dead has become increasingly challenging, most experts say the figure is likely an undercount and express shock at the enormity of the loss. Some military experts said more people had been killed more quickly in this war than during the deadliest stages of the U.S.-led wars in Afghanistan or Iraq.

Azmi Keshawi, the Gaza analyst for the International Crisis Group think tank, said this war was “more horrifying” than any he had experienced before. He said he and his family had fled his home in northern Gaza and moved six times so far. They now live in a tent near a U.N. shelter in the southern city of Rafah.

The Israeli military has engaged in an intense air and ground campaign to eliminate Hamas, the armed Palestinian group that rules Gaza and led the Oct. 7 attack that officials say killed about 1,200 people in Israel, including hundreds of soldiers.

The high death toll reflects how Israel has chosen to wage the war, using thousands of airstrikes, heavy bombs and artillery in a small territory densely packed with civilians who cannot escape. Israel has said Hamas built an extensive tunnel network underground to shield its fighters and weapons, putting civilian infrastructure and people on the ground in the line of fire.

The latest war between Israel and Hamas was already thought to be the deadliest conflict for Palestinians in the 75 years since Israel was established. According to the Palestinian Central Bureau of Statistics, an estimated 15,000 Palestinians were killed during the war surrounding Israel’s creation in 1948.

The deaths in the current conflict, if the figures from Gaza are accurate, have also exceeded the most widely cited estimate of the toll for the initial three months of the 1982 invasion of Lebanon. But as in Gaza today, researchers say the number killed in Lebanon may never be known with confidence because of the fog of war, even four decades later.

That estimate comes from an analysis of police and hospital records compiled in 1982 by the newspaper An Nahar, which at the time was among the Arab world’s most respected. It put the death toll at 17,825. But the paper said that tally was most likely an undercount, and in 1982, The New York Times reported that “numbering the dead correctly is virtually impossible” in Lebanon.

In the 1967 Middle East war, nearly 19,000 Egyptians, Syrians and others were estimated to have been killed fighting Israel, while a similar number — mostly Syrians and Egyptians — died in the 1973 war, according to The Associated Press. As in the Gaza and Lebanon wars, the exact tolls for these wars are also not known, but most of the dead were believed to be combatants.

In contrast, the Gaza Health Ministry, which is part of the Hamas-run government there, said Wednesday that about 70% of those killed are women and children. Authorities in Gaza never give breakdowns for how many of those killed are combatants. On Thursday, the ministry said the death toll was 20,057.

Israel claims it has killed some 7,000 Hamas fighters but has not explained how it arrived at that number.

The toll in Gaza is expected to rise significantly when Palestinians are able to dig out of the vast destruction that the war has wrought. A Gazan government spokesperson said Wednesday that in addition to the dead, 6,700 people are missing. Many are believed to still be buried in the rubble.

“The likelihood is that many people who are missing under the rubble will be determined to have been killed,” said Omar Shakir, the Israel and Palestine director for Human Rights Watch. For that reason, the death toll is “likely to increase even if the bombing were to stop today,” he added.

No independent organizations have been able to verify the Gaza death toll because of the difficulties of operating in the territory. And as the conflict has ground on, the casualty numbers have become more difficult to collect.

The Gaza Health Ministry compiles death toll data from the records of local hospitals and morgues, officials in the territory have said. But in recent weeks, the government media office said it had stepped in to help gather the figures after the Health Ministry’s facilities were bombed and 27 of the 36 hospitals in Gaza were rendered unusable by airstrikes amid an Israeli siege that has tightly restricted food, water, fuel and medicine from entering.

Frequent disruptions in communications caused by Israeli attacks on telecommunication towers, Israeli control of the enclave’s communication lines and fuel shortages have also made gathering information very difficult.

Mahmoud al-Farra, a spokesperson for the government media office, said the people collecting the data had to make the most of the “available possibilities” amid the fighting. “It’s hard to count them because the number of martyrs is large,” he added.

Throughout the war, the Gaza Health Ministry has released updated death tolls that have been called broadly reliable by the U.N., humanitarian groups and a study published this month in The Lancet, a British medical journal.

This month, when the ministry said the death toll had passed 15,000, some Israeli officials said they believed that figure to be roughly accurate. However, the Israeli military has also said the death toll reported in Gaza could not be trusted because the territory is run by Hamas.

On Oct. 26, the ministry released a list of the names and ID numbers of 6,747 people it said had been killed up to that point by Israeli bombing — an accounting that enhanced the credibility of its numbers.

The ministry’s staff includes many civil servants who predate the Hamas takeover of Gaza in 2007, and humanitarian groups have defended its record. They say it has a history of good-faith reporting and has provided reliable information.

But the ministry came under criticism after an Oct. 17 explosion at al-Ahli Hospital in Gaza City, when the government almost instantaneously released casualty figures that ranged from 500 to 833 dead. Days later, it announced a final count of 471.

After the explosion, John F. Kirby, a White House spokesperson, called the ministry “a front for Hamas,” and President Joe Biden told reporters he had “no notion that the Palestinians are telling the truth about how many people are killed.”

Biden then added: “I’m sure innocents have been killed, and it’s the price of waging a war.”

The war has posed myriad other complications for compiling accurate casualty counts.

An estimated 85% of Gaza’s population of more than 2 million have fled their homes, after Israel ordered the evacuation of much of the territory, to try to escape Israel’s airstrikes and ground invasion. Its largest population center, Gaza City, has been reduced to rubble. Thousands sleep on the street, and others live in overcrowded shelters that teem with disease.

There has been virtually no electricity for more than two months. Food and clean water are scarce. The U.N. says half the population is at risk of starvation, and 90% regularly go without food for a whole day.

Ahmed Fouad Alkhatib, a vocal critic of Hamas who grew up in Gaza but now lives in California, said Israeli airstrikes have so far killed more than 30 members of his family, including people in their 70s and cousins between the ages of 3 months and 9 years old.

Early in the war, he said, his childhood home was bombed, killing one young cousin. And last week, his aunt and uncle’s home was bombed, killing at least 31 people. Sitting in California, he watched video of their destroyed home on his phone. None of the people there were affiliated with Hamas, he said.

“It was a family home,” he said.

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This article originally appeared in The New York Times.

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