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White House spokesperson Karoline Leavitt has said Iran would be “wise” to make a deal, as the United States surges further military assets to the Middle East.

Her statement came as part of a series of veiled threats from officials under US President Donald Trump, a day after US and Iranian representatives held a second round of indirect talks this month.

The two sides appeared to offer differing accounts of the talks. Iranian officials said both parties had agreed on “guiding principles”, but US Vice President JD Vance said Iran had yet to respond to all of Washington’s “red lines”.

During a news conference on Wednesday, Leavitt articulated the Trump administration’s position that Iran needs to accede to US demands.

“Iran would be very wise to make a deal with President Trump and with his administration,” she told reporters.

Trump, who has repeatedly threatened Iran with military action in response to its crackdown on protests last month, also referenced a possible escalation in a post on Truth Social on Wednesday.

The post warned Prime Minister Keir Starmer of the United Kingdom against a deal agreed to last year that would see London cede control of the Chagos Islands, strategically located in the centre of the Indian Ocean.

The deal nevertheless allows the UK and US to continue to lease and operate a joint airbase on the largest island, Diego Garcia.

“Should Iran decide not to make a Deal, it may be necessary for the United States to use Diego Garcia, and the Airfield located in Fairford, in order to eradicate a potential attack by a highly unstable and dangerous Regime,” Trump wrote.

“An attack that would potentially be made on the United Kingdom, as well as other friendly Countries.”

Meanwhile, speaking from the sidelines of an International Energy Agency (IAE) meeting in Paris, France, US Energy Secretary Chris Wright warned that Washington would deter Tehran from acquiring nuclear weapons “one way or the other”.

“They’ve been very clear about what they would do with nuclear weapons. It’s entirely unacceptable,” Wright said.

Military buildup

The threats come as the US appears to be surging more military assets to the Middle East, raising the spectre of escalation.

As of Wednesday, the Pentagon had one aircraft carrier, the USS Abraham Lincoln, nine destroyers and three littoral combat ships in the region, with an anonymous US official telling the AFP news agency more were on the way.

That includes the world’s largest aircraft carrier, the USS Gerald R Ford, which is en route from the Atlantic Ocean.

The US has also sent a large fleet of aircraft to the Middle East, according to open-source intelligence accounts on X and flight-tracking website Flightradar24.

That deployment appears to include F-22 Raptor stealth fighter jets, F-15 and F-16 warplanes, and the KC-135 aerial refuelling aircraft that are needed to sustain their operations, according to the trackers.

The US had previously surged aircraft and naval vessels to the region ahead of strikes on three Iranian nuclear sites in June of last year, which came at the end of a 12-day war between Israel and Iran.

Iran does ‘not want war’

For his part, Iranian President Masoud Pezeshkian said on Wednesday that the country did “not want war” but would not give in to US demands.

“From the day I took office, I have believed that war must be set aside. But if they are going to try to impose their will on us, humiliate us and demand that we bow our heads at any cost, should we accept that?” he asked.

Pezeshkian spoke shortly after Iran’s Islamic Revolutionary Guard Corps launched exercises on Monday in the Strait of Hormuz, in a show of military might.

Iran’s Supreme Leader Ayatollah Ali Khamenei has previously warned that any new US strikes would lead to wider regional escalation.

Iran’s Ministry of Foreign Affairs said in a statement on Wednesday that its top diplomat Abbas Araghchi had spoken by phone with the head of the United Nations nuclear watchdog, Rafael Grossi.

Grossi “stressed the Islamic Republic of Iran’s focus on drafting an initial and coherent framework to advance future talks” on its nuclear programme, according to the statement.

Trump withdrew from the Joint Comprehensive Plan of Action (JCPOA), which saw Iran curtail its nuclear programme in exchange for sanctions relief, during his first term in 2018. In the years since, he has imposed a “maximum pressure” campaign that includes new sanctions.

Efforts to strike a new nuclear deal have repeatedly stalled since Trump’s first term.

Tehran has called for the latest round of talks to focus solely on its nuclear programme, which it maintains is used only for civilian purposes. It has also indicated it is willing to make concessions in exchange for the lifting of sanctions.

The true human cost of Israel’s genocidal war on the Gaza Strip has far exceeded previous official estimates, with independent research published in the world’s leading medical journals verifying more than 75,000 “violent deaths” by early 2025.

The findings, emerging from a landmark series of scientific papers, suggest that administrative records from the Gaza Ministry of Health (MoH) represent a conservative “floor” rather than an overcount, and provide a rigorous bedrock to the scale of Palestinian loss.

The Gaza Mortality Survey (GMS), a population-representative household study published in The Lancet Global Health, estimated 75,200 “violent deaths” between October 7, 2023 and January 5, 2025. This figure represents approximately 3.4 percent of Gaza’s pre-conflict 2.2 million population and sits 34.7 percent higher than the 49,090 “violent deaths” reported by the MoH for the same period.

The Gaza Health Ministry estimates that as of January 27 this year, at least 71,662 people have been killed since the start of the war. Of those, 488 people have been killed since the declaration of a ceasefire in the Gaza Strip on October 10, 2025.

Israel has consistently questioned the ministry’s figures, but an Israeli army official told journalists in the country in January that the army accepted that about 70,000 people had been killed in Gaza during the war.

Despite the higher figure, researchers noted that the demographic composition of casualties – where women, children, and the elderly comprise 56.2 percent of those killed – remains remarkably consistent with official Palestinian reporting.

Scientific validation of the toll

The GMS, which interviewed 2,000 households representing 9,729 individuals, provides a rigorous empirical foundation for a death toll.

Michael Spagat, a professor of economics at Royal Holloway University of London and the study’s lead author, found that while MoH reporting remains reliable, it is inherently conservative due to the collapse of the very infrastructure required to document death.

Notably, this research advances upon findings published in The Lancet in January 2025, which used statistical “capture-recapture” modelling to estimate 64,260 deaths during the war’s first nine months.

While that earlier study relied on probability to flag undercounts, this report shifts from mathematical estimation to empirical verification through direct household interviews. It extends the timeline through January 2025, confirming a violent toll exceeding 75,000 and quantifying, for the first time, the burden of “non-violent excess mortality”.

According to a separate commentary in the same publication, the systematic destruction of hospitals and administrative centres has created a “central paradox” where the more devastating the harm to the health system, the more difficult it becomes to analyse the total death toll.

Verification is further hindered by thousands of bodies still buried under rubble or mutilated beyond recognition. Beyond direct violence, the survey estimated 16,300 “non-violent deaths”, including 8,540 “excess” deaths caused directly by the deterioration of living conditions and the blockade-induced collapse of the medical sector.

Researchers highlighted that the MoH figures appear to be conservative and reliable, dispelling misinformation campaigns aimed at discrediting Palestinian casualty data. “The validation of MoH reporting through multiple independent methodologies supports the reliability of its administrative casualty recording systems even under extreme conditions,” the study concluded.

A decade of reconstructive backlogs

While the death toll continues to mount, survivors face an unprecedented burden of complex injury that Gaza’s decimated healthcare system is no longer equipped to manage. A predictive, multi-source model published in eClinicalMedicine quantified 116,020 cumulative injuries as of April 30, 2025.

The study, led by researchers from Duke University and Gaza’s al-Shifa Hospital, estimated that between 29,000 and 46,000 of these injuries require complex reconstructive surgery. More than 80 percent of these injuries resulted from explosions, primarily air attacks and shelling in densely populated urban zones.

The scale of the backlog is staggering. Ash Patel, a surgeon and co-author of the study, noted that even if surgical capacity were miraculously restored to pre-war levels, it would take approximately another decade to work through the estimated backlog of predicted reconstructive cases. Before the escalation, Gaza had only eight board-certified plastic and reconstructive surgeons for a population exceeding 2.2 million people.

The collapse of the health system

The disparity between reconstructive need and capacity is exacerbated by what researchers describe as the “systematic destruction” of medical infrastructure. By May 2025, only 12 of Gaza’s 36 hospitals remained capable of providing care beyond basic emergency triage, with approximately 2,000 hospital beds available for the entire population, down from more than 3,000 beds before the war.

“There is little to no reconstructive surgery capacity left within Gaza,” the research concluded, warning that specialised expertise like microsurgery is almost absent. The clinical challenge is further compounded by Israel’s use of incendiary weapons, which produce severe burns alongside blast-related fractures.

The long-term effect of these injuries is often irreversible. Without prompt medical treatment, patients face high risks of wound infection, sepsis, and permanent disability. The data indicate that tens of thousands of Palestinians will remain with surgically addressable disabilities for life unless there is a huge international increase in reconstructive capacity and aid.

The ‘grey zone’ of mortality

Writing in The Lancet Global Health, authors Belal Aldabbour and Bilal Irfan observed a growing “grey zone” in mortality where the distinction between direct and indirect death becomes blurred. Patients who die of sepsis months after a blast, or from renal failure after a crushing injury because they cannot access clean water or surgery, occupy a space that risks understating the true lethality of military attacks.

Conditions have only deteriorated since the data collection periods. By late 2025, forced evacuations covered more than 80 percent of Gaza’s area, with northern Gaza and Rafah governorates facing full razing by Israeli forces. Famine was declared in northern Gaza in August 2025, further reducing the physiological reserve of injured survivors and complicating any surgical recovery.