How the Gaza hospital explosion set off a furious scramble before Biden's Israel trip

A deadly blast at a hospital in Gaza hours before President Joe Biden was set to leave the White House for the Middle East set off a furious scramble inside his administration as the president's advisers tried to ascertain who was responsible as street protests against Israel started raging across the Arab world.

Hours later, the president and his national security team were not confident enough to draw a final determination absolving Israel of responsibility. But the initial information they evaluated strongly suggested that the Israelis were not behind the strike, serving as a green light for Biden's motorcade to roll out to Joint Base Andrews late Tuesday afternoon, sources familiar with the internal deliberation told CNN.

Had the early evidence examined by the president's team pointed in the other direction, the White House would have been more inclined to reconsider the trip. But advisers were sensitive about reversing course mere hours after the trip was announced by Secretary of State Antony Blinken, and in the end, they never came close to canceling the trip altogether, sources said.

"He had no choice. Once he decided to do it, he wouldn't cancel it," one source said, describing what was understood to be an extraordinarily high bar for canceling Biden's visit, which only included a stop in Tel Aviv after Arab leaders canceled a planned summit with Biden in Amman, Jordan, in response to the hospital explosion.

The first public statement from the White House on the blast - which authorities in Hamas-run Gaza have said killed hundreds of civilians - condemned the civilian casualties and said the administration would continue studying the intelligence. En route to Israel on Air Force One, White House spokesman John Kirby would only go as far as to say, "We certainly recognize that they feel very strongly that - that this was not caused by them," when asked whether the US would give Israel "the benefit of the doubt."

Back at home, Biden's team worked through the night, delivering an initial intelligence assessment in the early morning hours Wednesday, according to a source familiar. The president was briefed on that assessment, leading him to be explicit about who was to blame for the hospital strike: "Based on the information we've seen to date, it appears the result of an errant rocket fired by a terrorist group in Gaza."

Officials told CNN separately that the initial evidence gathered by the US intelligence community suggests that the hospital strike came from a rocket launched by the Palestinian Islamic Jihad group and the National Security Council said in a statement on Wednesday that the US assesses that Israel was not responsible for the attack.

A casual, off-the-cuff reference to the Palestinian Islamic Jihad, the militant group the US believes is behind the hospital attack, as "the other team" undercut the diplomatic force established by the visit; the comment was clarified in later remarks, in which Biden blamed "errant rocket fire from a terrorist group in Gaza."

A day after the explosion ripped through the Gaza hospital, Biden was back on Air Force One - after an expected 20 hours of travel for less than eight hours on the ground - with few tangible accomplishments to tout.

During a refueling stop in Germany on the way home from Israel, Biden told reporters there was virtually no pushback from regional leaders when the US urged them to allow aid into areas governed by Hamas. Biden said that, if Hamas confiscates the supplies meant for civilians, the aid will end.

Biden said he spent the refueling stop speaking by phone to Egyptian President Abdel Fattah el-Sisi, who agreed to allow 20 trucks through the Rafah crossing. Former Ambassador David Satterfield, tapped to coordinate the US's humanitarian efforts, will arrange the transport of the trucks, which Biden estimated could happen on Friday after potholes in the road are repaired.

The postponement of the highly anticipated summit with Arab leaders in Jordan - where humanitarian issues were expected to be front and center - denied Biden a coveted opportunity to meet face-to-face with key partners in the region.

One senior US official said the cancellation of the Jordan visit was "definitely a setback," but that the trip was still viewed as worthwhile because it "buys us some time" when it comes to a potential Israeli ground invasion of Gaza. The official said that the longer the Israelis hold off on a ground incursion into Gaza the better, because it would allow Israel to plan more strategically and not respond as emotionally to the horrors of October 7.

Advisers had appeared determined to reorient expectations before Biden had even arrived in Israel, saying that showing the powerful visual of American solidarity with Israel was a major goal of the trip. They described Biden and his longtime partner Prime Minister Benjamin Netanyahu standing shoulder-to-shoulder - and the US leader willing to take significant risks to back up his rhetorical warnings to any rogue actors in the region - as a critical deliverable.

One adviser put it simply: Biden sent a "strong message to Israel, which was the purpose of it."