Boris Johnson Heads to Brussels for Dinner and, Perhaps, a Brexit Deal

LONDON — As Prime Minister Boris Johnson of Britain headed to Brussels on Wednesday for critical talks on post-Brexit trade with the European Union, economic logic suggested he badly needs a deal. But having campaigned for Brexit on the basis of reclaiming national sovereignty, Mr. Johnson faces a tough task in reaching any agreement acceptable to both the bloc and Brexit supporters back home.

With an endgame fast approaching, Mr. Johnson was scheduled to meet with Ursula von der Leyen, the president of the European Commission, the bloc’s executive body, over dinner for talks that could determine the shape of Britain’s relations with continental Europe for decades to come.

On Thursday, European Union leaders are set to gather in Brussels with other important issues on their agenda, like the next seven-year budget, the coronavirus recovery fund, the rule of law and possible sanctions on Turkey.

If the Brexit trade discussions go badly Wednesday night, the talk may shift to how to cope with the failure to strike a deal, and how to limit disruption in January when an abrupt switch in the terms of commerce could leave ports blocked and trucks stranded. But the Europeans are agreed that they will not be the ones to pull the plug on negotiations.

The German chancellor, Angela Merkel, remained upbeat on Wednesday about the trade negotiations, saying “there is still the chance of an agreement.” But she stressed that the European Union would not accept any deal “if there are conditions from the British side that we can’t accept” or that threatens the single market.

A breakthrough over dinner, should it come, would give momentum for a final push to strike the elusive trade agreement that many analysts have expected to emerge, theatrically, not long before the Dec. 31 deadline.

Inevitably, given the acute sensitivities, the signals have been mixed, with both sides stressing the distance that must be traveled to strike an accord.

The Irish foreign minister, Simon Coveney, has expressed his belief that there will be some “thin” deal, a bare minimum agreement, but that the last hurdles are always the most difficult. “I think the negotiating teams and senior politicians will find a way of getting a deal,” he said, “but at the moment we’re in a difficult place as we try to close it out.”

But even Mr. Coveney, who is a good barometer of European sentiment, is becoming more gloomy. He said Monday night, after a meeting of bloc foreign ministers, that the mood was shifting toward preparations for going forward without a deal. There is “a great deal of frustration on the E.U. side, not just within the E.U. negotiating team” but “also across member states,” Mr. Coveney said.

One outstanding issue was resolved on Tuesday when London dropped a threat to break its withdrawal treaty — and to breach international law — over how it would implement rules on the flow of goods between Britain and Northern Ireland.

Yet, the three main issues that have prevented them from striking a trade deal remain unresolved: fishing rights, the rules on state subsidies and “level playing field” provisions to ensure fair competition between British and European companies, and the mechanisms to enforce them.

While access to fishing stocks is an extremely sensitive political issue for Britain, France and other coastal European nations, the other two issues are probably more difficult to resolve, because they touch on the hypersensitive principles of sovereignty.

The biggest gap is over the terms of fair trade, because officials in Brussels fear that, as a large economy on Europe’s doorstep, Britain could adopt lower labor or environmental standards, flood the European market and undercut continental companies.

But at this point, Mr. Johnson faces a dilemma. Negotiators in Brussels want the right to impose tariffs on imports should Britain diverge from Europe’s standards. Given that Britain says it does not, in general, intend to adopt lower standards, it might never have to confront such a situation. But if Britain fails to strike a trade deal it would definitely face tariffs.

Rather than a dry and technical trade issue, Mr. Johnson sees this as a European attempt to tie Britain to the bloc’s future rule book, trampling the national sovereignty that was at the heart of his vision for Brexit.

Mr. Johnson told lawmakers on Wednesday that a good deal was still possible. But he added that if Britain failed to follow future European rules, Brussels wanted the “automatic right to punish us and to retaliate,” adding that no British prime minister should accept such terms.

Hard-liners within his own party have amplified that argument, appealing to him not to compromise in the discussions with Ms. von der Leyen.

“The reality is that this is all about sovereignty,” Iain Duncan Smith, a former leader of the Conservative Party and a Brexit enthusiast, wrote in The Daily Telegraph. “From the beginning, it has been clear, whilst the U.K. wants a trade deal, E.U. wants to control us. Either the U.K. is sovereign or it is not.”

Yet the price of exercising complete sovereignty could be very high. Failure to strike a trade deal could well be exploited by pro-independence campaigners in Scotland, where a majority of voters opposed Brexit in a 2016 referendum. It would also wipe an additional 2 percent off British economic output while driving up inflation, unemployment and public borrowing, official forecasts said last month.

While European nations would suffer, too, none — with the possible exception of Ireland — would be hit as hard as Britain. Senior French officials, like the Europe minister, Clément Beaune, have said that France is ready to veto an unsatisfactory deal, and Dutch officials have suggested that the European Union’s chief negotiator, Michel Barnier, is coming very close in his negotiations to crossing “the red lines” of his mandate.

Ms. Merkel stressed the need for Britain to adhere closely to the bloc’s rules on labor, the environment and fair competition, as well as for mechanisms to police any agreement.

“We must have a level playing field not just for today, but we must have one for tomorrow or the day after, and to do this we must have agreements on how one can react if the other changes their legal situation,” Ms. Merkel said. “Otherwise there will be unfair competitive conditions that we cannot ask of our companies.”

The Europeans are adamant that the mandate will not change and that Mr. Barnier has their confidence. While European nations may have differing priorities, their leaders say that they will not break the solidarity shown so far, and that their formal role will be simply to endorse any deal Mr. Barnier can reach — or acknowledge that the talks have failed.

How this gets resolved — how far Britain must keep to rules set in Brussels and how to settle any disputes that arise — remains at the heart of the continuing disagreements. But selling any deal that emerges is another matter entirely.

Stephen Castle reported from London, and Steven Erlanger from Brussels.

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Children’s hospitals are pitching in to help with the flood of adult Covid-19 patients.

With a rising tide of Covid-19 patients threatening to overwhelm hospitals, public health officials across the United States are reaching for a safety valve that the Northeast used in the spring: borrowing beds in children’s hospitals to care for adults.

U.S. hospitalizations are at a record-high of 104,600, according to the Covid Tracking Project, and the nation set a record this past week for the most deaths in a seven-day period.

“As the fall came into play and the second surge hit, I think we’re seeing a lot more of that happening now,” said Amy Knight, president of the Children’s Hospital Association, a national group representing more than 200 U.S. facilities.

It’s rare for American children’s hospitals to admit adult patients or loosen their admittance criteria, so the fact that it is being done now speaks to the severity of the crisis, according to Dr. Peter Jay Hotez, a professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and the co-director of Texas Children’s Hospital Center for Vaccine Development.

“I don’t even know if this was done during H1N1 in 2009, so I can’t think of too many modern precedents,” he said.

Because coronavirus infections seem to largely spare younger children, compared with teenagers and adults, children’s hospitals and the pediatric wards of general hospitals tended not to become swamped early in the pandemic.

“It was more like a trickle of kids that needed to be hospitalized,” Ms. Knight said.

Since then, however, the number of children becoming infected and needing hospital care has risen sharply, and children’s hospitals may have less room and resources to spare at a time of year when the need for pediatric beds tends to rise anyway because of influenza.

“We’re much more limited in capacity for pediatric critical illness throughout the country,” said Dr. Brian Cummings, who works in the intensive care unit at MassGeneral Hospital for Children in Boston. “Clearly we’re overwhelming the adult I.C.U. capacity, and then to use an even scarcer resource really does concern all of us that advocate for children.”

Even so, children’s hospitals are pitching in to help with the coronavirus surge in various ways. The Children’s Hospital Association released guidelines in April for several possible approaches, including taking in pediatric patients from general hospitals to free up space in those facilities, and raising their maximum admission ages.

The St. Louis Children’s Hospital, a part of BJC HealthCare, started opening its doors to adult patients in November, and another pediatric hospital in St. Louis, Cardinal Glennon Children’s Hospital, has been accepting adult transfers who do not have Covid-19. Oishei Children’s Hospital in Buffalo said it would temporarily raise its admission ceiling to admit patients up to 25 years old.

During the first big surge in the Northeast, from April to June, MassGeneral Hospital for Children took adult patients in its 14-bed intensive care unit. “As we watched hospitals become overwhelmed, everyone wanted to step up and do their part,” Dr. Cummings said.

The unit went back to normal over the summer, but with cases trending upward again in Massachusetts, he said, “we are definitely worried that we’re going to have patients again in the next week or two.”

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One pandemic, two presidents: A split-screen moment underscores the clashing approaches of Trump and Biden.

The current president hailed a “monumental national achievement.” His successor grimly described a “mass casualty” event.

The remarks about the coronavirus pandemic by President Trump and President-elect Joseph R. Biden Jr. on Tuesday offered a striking, split-screen moment, underscoring how differently the two men are approaching the worst public health crisis in 100 years that has taken a particularly devastating toll on people of color.

Speaking in Wilmington, Del., as he introduced the people who will lead his health care agencies, Mr. Biden painted a grim picture of the infections ravaging the nation even as he vowed to get “at least 100 million Covid vaccine shots into the arms of the American people” during his first 100 days in office.

He pledged to run “the most efficient mass vaccination plan in U.S. history” but did not say how and through what companies his administration would purchase vaccine shots. Mr. Biden also implored Americans to wear masks during his first 100 days in office and said he would make doing so a requirement in federal buildings and on planes, trains and buses that cross state lines.

“My first 100 days won’t end the Covid-19 virus — I can’t promise that,” Mr. Biden, speaking at a virtual event in an almost empty room, said. But he added, “I’m absolutely convinced we can change course.”

The senior officials Mr. Biden will appoint — including Xavier Becerra, a former congressman who is now the California attorney general, as his nominee for secretary of health and human services — will face the immediate challenge of slowing the spread of the coronavirus, which has already killed more than 285,000 people in the United States and has taken a particularly devastating toll on people of color.

Other health officials included in the event were Dr. Marcella Nunez-Smith, who will lead a Covid-19 equity task force, and Jeffrey D. Zients, the incoming coordinator of the Covid-19 response.

It was a much more upbeat message at an auditorium near the White House, where Mr. Trump packed industry officials and members of his administration — most of them wearing masks — for a “vaccine summit” to celebrate the expected approval of a vaccine by the Food and Drug Administration this week.

The dueling scenes came as Britain began vaccinating people in the wake of that country’s approval of the Pfizer-BioNTech vaccine — the same one on the verge of approval in the United States. In Britain, scenes of people receiving the first doses of the vaccine dominated television coverage offering a bit of good news in the fight against the virus.

Asked why he had not included members of Mr. Biden’s transition team in the summit to ensure smooth delivery of the vaccine by the next administration, Mr. Trump again complained, without evidence, that people had tried to “steal” the election and said he hoped the next administration would be “the Trump administration.”

Mr. Trump, who entered to a recording of “Hail to the Chief” and stood in front of a backdrop with American flags, claimed credit for the vaccine, thanking his White House staff and advisers — though he pointedly excluded Dr. Anthony S. Fauci, the nation’s leading infectious disease specialist, who has been tapped by Mr. Biden to be his chief medical adviser and appeared remotely at the president-elect’s event.

Mr. Trump barely mentioned the surge in cases and deaths across the country in recent weeks, only repeating his longstanding — and false — assertion that the United States only has more cases because it does more testing. The country has shattered record after record as it approaches 300,000 deaths and surpassed 15 million known cases amid a brutal and accelerating surge. As of Monday, the nation recorded the most virus-related deaths over a weeklong period — about 2,200 daily — and an average of more than 201,000 cases a day.

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