In Israeli hospitals, health officials are preparing isolated areas where hostages can begin to recover in privacy. The Israeli Ministry of Health has drawn up an extensive protocol for their psychological and physical treatment. There is particular concern that they may be severely malnourished.

“Those who were freed then were already malnourished,” Hagar Mizrahi, a senior official at Israel’s health ministry, said of the hostages freed during the 2023 ceasefire. “Imagine their situation now, after an additional 400 days. We are extremely concerned about this.”

After Hamas led an attack on Israel on October 7, 2023, killing around 1,200 people and capturing around 250 others, around 105 Israeli and foreign hostages were freed in a week-long ceasefire in November of that year. Several were later released in Israeli military operations, and Israeli soldiers recovered the bodies of dozens of others.

But about 98 hostages remain in Gaza, with dozens believed to be dead by Israeli authorities.

Many of the women, elderly men and other hostages returned under the first phase of this ceasefire deal are believed to have been held in the militant group’s tunnels in Gaza, in conditions likely to leave physical and psychological scars.

Health officials were studying every piece of intelligence — including video footage of the hostages — in an effort to discern the condition of the hostages, said Dr. Mizrahi. The board of officials in which dr. Mizrahi found that some were killed.

Israeli officials say the logistics of the release will be largely similar to those during the previous ceasefire, when 105 hostages were released in exchange for 240 Palestinians imprisoned in Israel.

In that exchange, Hamas fighters handed over the hostages – mostly women and children – to the International Committee of the Red Cross. Red Cross workers transported the prisoners from Gaza in a marked ambulance to Egypt before taking them to Israel.

At the border crossing, Israeli intelligence officers checked their identities. Around the same time, Israeli security officials released a group of Palestinian women and teenage prisoners.

This time, Israeli authorities set up three reception points to receive hostages along the Gaza border, according to an Israeli military official. They will include Israeli soldiers, as well as doctors and psychologists, said the official, who spoke on condition of anonymity in accordance with protocol.

From there, the hostages will be taken to Israeli hospitals that have been prepared for them, the official said.

The 105 hostages freed in November 2023 returned home after approximately 50 days of captivity in Gaza. They arrived in a country that had fundamentally changed; some only then learned of friends and loved ones killed in the Hamas-led attack.

Initially, officials aimed to reintegrate the returning hostages as soon as possible, according to Dr. Mizrahi. Now, health authorities recommend that hostages who are released stay in the hospital for at least four days, if not longer, she said.

Meanwhile, family members of the hostages – some of whom survived captivity themselves – can only wait.

“Last time we saw the Red Cross moving hostages, and some of them ran to their relatives, hugging them,” said Einat Yehene, a clinical psychologist who works with the Hostage Families Forum, an advocacy group. “It won’t be easy this time, given the physical and emotional conditions we expect.”