One month after MinuteClinic struck a heady deal to link EMRs with the Cleveland Clinic and one week before the US government announced a health emergency due to Swine flu, the CVS Caremark subsidiary announced it planned to shutter 16% of its locations during spring and summer, normally the off-season for colds and flu.

Industry experts claimed that poor business performance during these periods represented “a structural flaw” in the retail clinic business model, and predicted a gloomy future for all but those with storefronts in close proximity to, or otherwise affiliated with hospitals and physician groups.

That’s because provider-associated retail clinics have large enough catchment populations to sustain themselves year-round, or at least offset lower off-season traffic with business at other venues and facilities.

MinuteClinic’s decision risks nullifying the very image of convenience that drives success in the first place, according to Tom Charland, CEO of Merchant Medicine, a consultancy specializing in retail clinics.

“You can’t preach convenience and consistency out of one side of your mouth and then have it sort of up in the air as to whether that clinic is open or not,” Charland told AMedNews.

With over 500 stores, MinuteClinic is the largest retail clinic chain in the US. It’s not clear whether other clinic chains will follow suit, or how the Swine flu scare might shuffle the deck.

The retail clinic business is not for the faint of heart.

On average, it takes 3 years before outlets turn a profit, and many fold before then.

CheckUps for example, closed 23 of its Wal-Mart housed clinics in January 2008, and last summer SmartCare shuttered 15 venues which had also been housed in Wal-Mart.

Still, the number of retail clinics continues to rise.

About 1,100 clinics are open today, as compared with only 200 at year end, 2006.

And soon after announcing the seasonal shutdowns, MinuteClinic itself opened several new, year-round locations in Massachusetts.

They’re stocking up on Tamiflu and Relenza as we speak.

Yesterday afternoon, the Obama administration declared a public health emergency in response to a swine flu outbreak that has affected 20 US citizens. It is the same strain that has killed 81 people in Mexico.

Homeland Security Secretary Janet Napolitano described the move as “precautionary” and said the Feds planned to release 25% of the 50 million treatment courses of Tamiflu and Relenza it has stockpiled, just in case.

The CDC has confirmed 8 cases in New York City, 7 in California, 2 in Texas and Kansas, and 1 in Ohio. All have been mild and only one person has required hospitalization so far. 

Richard Besser, the CDC’s Acting Director said however, that he expected to see “more serious illness” this week.

Anne Schuchat, the CDC’s interim deputy director of science and health echoed that sentiment and upped it one. “I fear we will have deaths here,” she was reported to have said by MedPageToday.

The agency is trying to figure out why the virus seems to be targeting young adults, Schuchat added.  One theory is that older folks have previously been exposed to H1N1 viruses–which have contributed some to the current virus’ genetic make-up–so they’re partially immune to the new bug.

The CDC has already obtained specimens of the new pathogen from which it can develop a vaccine “if that is necessary,” said Besser. In addition, it has put vaccine manufacturers on speed dial.

Tamiflu, a pill, is made by Roche and Gilead. Relenza is inhaled. It’s produced by GlaxoSmithKline and Biota. Both drugs appear to be effective against this virus, so long as they are given quickly after symptom onset.

The Big O recently visited Mexico, but he’s shown no symptoms so he’s not been tested.