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With roughly 90% of Gaza residents displaced and seeking safety from Israel’s bombardment and ground attacks, crowding into shelters in cities including the already densely populated Rafah, humanitarian agencies warned Tuesday that the spread of disease and the risk of starvation are showing no signs of slowing down in the blockaded enclave.

A week after the World Food Program (WFP) warned that about “half of Gaza’s population is starving,” the United Nations organization’s chief economist said Tuesday that less than three months into Israel’s relentless assault, the territory appears to meet at least one of the criteria for famine.

About 20% of the population faces an “extreme lack of food,” Arif Husain told The New York Times.

“I’ve been to pretty much any conflict, whether Yemen, whether it was South Sudan, northeast Nigeria, Ethiopia, you name it,” Husain told the newspaper. “And I have never seen anything like this, both in terms of its scale, its magnitude, but also at the pace that this has unfolded.”

Skipping meals, particularly among adults caring for children, has become “the norm” in Gaza, the WFP said on social media.