Here's the thing - Hamas isn't actively killing Israeli civilians anymore. You can argue that if we don't fully wipe Hamas they will in the future, but right now, almost exclusively Gaza civilians are being killed. That ratio isn't 45:1 today, it's closer to 4500:1.
Is it really surprising that a government that started a war while spending zero dollars on air superiority, zero dollars on artillery, zero dollars on defensive fortifications, zero dollars on civilian bomb shelters, zero dollars on radar and enemy detection and zero dollars on a military college for its officers is losing the war it started with a 45:1 casualty ratio?
If Israel were truly trying to maximize harm in Gaza it could easily be 4500:1.