Swine flu in 2009, bird flu in 2017, and now coronavirus in 2020. Karin Valenza has now experienced three worldwide epidemics coming out of China during the last 10 years she has lived in Shanghai.

A native lakes area resident and 1997 Brainerd High School graduate, Valenza teaches middle school math at Shanghai Community International School. Her kids — nearly ages 11 and 13 — attend school there.

In early January, Valenza’s mom, Hope Paulson, traveled to Shanghai for a previously scheduled visit with her daughter and grandkids while they were on vacation for the Chinese New Year. The trip was planned and executed before the deadly coronavirus outbreak was widely known. Paulson got the chance to attend a carnival at the kids’ school and go to Shanghai Disneyland before the family became quarantined in Valenza’s house due to the virus scare. Now, all four have to leave the country.

The World Health Organization declared a global health emergency Thursday, Jan. 30, as more than 7,800 cases of coronavirus had been confirmed at that time. A global health emergency, according to the WHO, is declared when there is a public health risk to more than one country through the international spread of a disease and when a coordinated international response is required.

Last Sunday, Jan. 26 — just before holing themselves up at home for the foreseeable future — Valenza and Paulson covered their mouths, suited up with gloves and braved the outside world for a trip to Costco to restock their dwindling food supply, Valenza wearing the one mask she had and Paulson wearing her granddaughter’s bandana over her mouth. They woke up early to start the hour-long drive so they could arrive when the store opened, assuming crowds would get large later in the day. The story was out of masks — as are most pharmacies across China — but they managed to get two carts full of groceries. By the time they left, the aisles were so packed with people they said it was hard to move. Most everyone, save for two people Paulson noticed, had their faces covered. One Chinese man who caught their attention even had swim goggles covering his eyes and a hood up over his head.

After showering right away when they got home — and not interacting with the kids before — the first items from the shopping trip they brought in were rubber gloves for the kids and Clorox wipes, which they spent four hours using to disinfect everything they bought.

“We would wipe everything down, hand it to them (the kids), and they would take it to the kitchen or the dining room table and so on. It was exhausting,” Paulson said during a FaceTime interview Wednesday, Jan. 29 — Thursday morning Shanghai time.

Then they canceled the rest of their vacation plans for massages, manicures, pedicures and a theatrical showing of “Beauty and the Beast” at Disneytown, just outside of Disneyland. Instead, they’ve been cooped up in Valenza’s house for about a week now, playing board games (including Brainerdopoly) and card games, exhausting content on Netflix and Disney+ and doing whatever they can to pass the time.

Valenza also allows the kids to ride their bikes outside for a little while each day, as long as they wear masks and gloves and promptly shower and disinfect when they get back.

Valenza and her kids had a week-long vacation last week for Chinese New Year — the biggest holiday of the year in the country. They were scheduled to return to school Monday, Feb. 3, but that’s not going to happen.

Valenza said school officials tentatively planned to reopen the school Feb. 17, while doing online learning until then. Even that date, though, looks like it will be too soon after the U.S. Department of State issued a Level 4 “do not travel” warning for China. Those currently in China, the state department said, should think about leaving using commercial means.

Valenza chose not to buy plane tickets out of the country for spring break and summer vacation, as she doesn’t know what the status of the epidemic will be then or if the school year will have to be extended.

Meanwhile, Paulson, a summertime Baxter resident, planned to return to her winter home in Fort Myers, Florida, Feb. 10. That, too, however has changed. On Thursday, Paulson said in an email they learned all “non-essential” personnel were encouraged to leave China if they could, meaning she will fly out Feb. 4 — about a week earlier than she had planned — and Valenza and the kids will go with her. Administrators at Valenza’s school left China Friday.

Now, the family is praying their Delta flight won’t be canceled. On Friday, Delta announced its plans to suspend all U.S. to China through April 30. The China-bound flight departing the U.S. will leave Monday, Feb. 3, and the last return flight will depart China Feb. 5 to ensure customers looking to leave China have the option to do so.

Assuming their flight runs as planned, when they arrive at the Atlanta airport after their flight out of Shanghai the family will be screened for any signs of the virus. The CDC says travelers arriving in the U.S. from China will be asked to fill out a short questionnaire about their travel and symptoms. CDC staff will then take each traveler’s temperature with a hand-held non-contact thermometer and observe any coughing or difficulty breathing. If sick travelers are identified, the CDC will evaluate them further to determine if they should be taken to a hospital for care. Those who appear healthy will receive information cards outlining what kinds of symptoms to look out for and what to do if they develop symptoms within the next 14 days.

Paulson plans on carrying out a self-imposed 14-day quarantine when she gets back, just to be safe.

Before deciding to leave China, Paulson and Valenza said they were grateful for their stockpile of food, a water filter and internet. Valenza said she has friends who are in the process of moving and aren’t able to get internet set up right now. And the water in China, she said, can have an abundance of metal in it, but she is lucky enough to have a built-in filter at home, which not everyone does.

While they said Wednesday night they were comfortable at Valenza’s house in Shanghai for the time being, they were grateful for the option of leaving if they needed to, unlike the native Chinese, for whom China is home and who may not have anywhere else to go.

The women said they had been living on the peace of the Lord, praying about making the right decision when considering staying or leaving, and weighing the pros and cons of staying in country where the disease originated or flying back to the states and having to endure the busy Shanghai airport and being in close proximity with other passengers while on a plane.

Now that Valenza decided to leave China too, another problem arises. She plans to go to Florida with Paulson for comfort’s sake to be somewhere familiar if she were to be detained or quarantined, but her Chinese health insurance is not valid in North America.

“For me, honestly, of all the places, the U.S. would be the one that I would be the most comfortable with, but the hard part for me is that we don’t have any health insurance there,” Valenza said.

To make matters even trickier, Valenza’s 10-year-old son Tate needs to take lifesaving medication every day that she’ll now have to pay for out of pocket in the U.S. And if he gets sick in the midst of the epidemic, his health could rapidly decline.

Last fall, Tate was diagnosed with Addison’s Disease, an adrenal disorder in which his body does not produce enough of the steroid hormone cortisol, which influences the body’s ability to convert food into energy, plays a role in the immune system’s inflammatory response and helps the body respond to stress.

After a nightmarish 17 days in the hospital, Tate now has to take hormone replacement medication. But if he gets sick — a fever, cold, sore throat, etc. — or is under other physical stress, he would have a harder time fighting off any infections than most people and would have to increase his medication to stress dosage to continue producing enough cortisol and to properly respond to any other medicine he might need to fight an illness.

“So he’s not more susceptible (to illness),” Valenza said, “but if he does get sick, it can get really bad really fast.”

And with Valenza and her kids now not being able to return to Shanghai until after April 30 with Delta’s flight suspension, the mother had a lot of unanswered questions as of Friday. Will she still get paid for her time off from work? How will her kids attend school? Administrators at Valenza’s school — which includes three campuses and more than 1,700 students — have not yet set up online learning tools, nor have teachers or students been trained to use solely online resources. And perhaps one the biggest questions: Will Valenza be able to find affordable health insurance in the U.S. to cover Tate’s medicine? Right now, all of those factors are unknown. But the family will take things one day at a time and — Paulson said — will continue living on the peace of the Lord.

About coronavirus

Coronaviruses are a large family of viruses causing respiratory illness, including Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). Novel coronavirus (2019-nCoV) is a new strain spreading throughout the world right now. Symptoms of the strain include fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, kidney failure and even death, according to the WHO.

As of Friday afternoon, Jan. 31, the confirmed number of cases rose to more than 9,700 throughout the world, and the death toll was over 200 — all in China, according to the Johns Hopkins University Center for Systems and Engineering. Outside of China, more than 100 cases were confirmed in 22 countries and three other Chinese territories — Hong Kong, Taiwan and Macau.

The U.S. is up to six confirmed cases. Thursday, the Centers for Disease Control and Prevention reported the first person-to-person transmission of coronavirus in the U.S. A woman from Chicago experienced symptoms shortly after returning home from a trip to Wuhan, the original site of the outbreak. She then passed the virus onto her husband, who had not been to China.

As of Friday, a live map from the Johns Hopkins University Center for Systems Science and Engineering showed 112 confirmed cases and one death from coronavirus in Shanghai, the city of more than 24 million people where Valenza lives.

THERESA BOURKE may be reached at theresa.bourke@brainerddispatch.com or 218-855-5860. Follow her on Twitter at www.twitter.com/DispatchTheresa .