spoke Friday night at

, which has operated for less than a week.The International Committee of the Red Cross said in a statement its field hospital in Rafah received 179 casualties including women and children, 21 of them declared dead upon arrival, the majority with gunshot or shrapnel wounds. It was unclear if any of the dead were militants.

“All patients said they had been trying to reach an aid distribution site,” the ICRC said, calling it the highest number of “weapon-wounded” people in a single incident since the hospital was set up over a year ago.The head of the World Food Program, Cindy McCain, told ABC News that staffers on the ground were reporting people killed and called it a “tragedy.”“Aid distribution has become a death trap,” the head of the United Nations

, Philippe Lazzarini, said in a statement.In a separate statement, Israeli military chief of staff Lt. Gen. Eyal Zamir ordered that more aid sites be established — and that troops’ ground operation be expanded in unspecified parts of northern and southern Gaza.

on crowds near the foundation’s sites. Before Sunday, 17 people were killed while trying to reach them, according to Zaher al-Waheidi, head of the Gaza Health Ministry’s records department.

The foundation says private security contractors guarding its sites have not fired on crowds. Israel’s military has acknowledged firing warning shots on previous occasions.In previous administrations, health secretaries held weekly briefings with CDC staff, lasting between 25 and 30 minutes, during infectious disease outbreaks, both former HHS officials said. Kennedy, instead, received updates on paper or through email, Griffis said.

“That is extremely unusual,” said Griffis, who sat in on such briefings with the previous health secretary and said that none were held for Kennedy during his first month on the job. “I’ve never seen that before.”In another irregularity, the American Academy of Pediatrics, the nation’s largest network of pediatricians, has not been tapped to work with the CDC on the outbreak, according to the organization’s officials. Historically, the CDC and AAP have convened for monthly or biweekly briefings during outbreaks to share updates, which include details about what doctors are seeing and questions they’re fielding from parents in exam rooms. The officials spoke on the condition of anonymity to freely discuss the health department’s response.

The only updates provided widely to pediatricians by the CDC have come from a health alert network update sent on March 7, a week after the first U.S. measles death in a decade, and the letter sent to providers last week, which, according to the pediatric academy officials, was late in the outbreak.Kennedy praised the CDC on Tuesday during an event in Indianapolis, saying it “had done a very good job controlling the measles outbreak.”