If someone has a DT wipeout after QTing fish, it would likely be due to not properly QTing corals, inverts, CUC, macro algae etc. Before adding them to the tank.
Can SOME fish live in ich management, why yes of course, but is this any more ethical or natural than maintaining a disease free DT? I know it's a controversial topic. I just don't see the point in taking a chance with how rampant things like velvet, uronema, and of late gram negative bacteria have become in this industry. Of course this will depend on the type of fish you desire to keep as well. I don't see too many people keeping Acanthurus tangs with much success in an "immunity" or ich management tank as I like to call it.
Thank you - excellent reply.
I will address your points and then add a few of my own in the style of "old-fashioned discussion".
(Sorry in advance for the length....posted some good links that will hopefully make the length worth it.

)
A wipeout could also be from a carrier fish that made it through QT+meds, improper QT+meds, or just a fish that had a pathogen other than what the formula hypothetically covers...something with a different "76 days" number, or something more resistant, etc, etc. "Life will find a way" to quote a stupid movie.
Looking at things like algae and snails for your vector is really reaching even if it's theoretically possible. Even fewer folks QT those than QT their fish - almost nobody. If they were a real vector of concern, the hobby ought to be completely fishless.
Plenty of folks have kept tangs successfully without our peculiar version of "QT" too.
There's no such thing as an "immunity tank" or "ich management tank"....those are made up terms just for the benefit of this QT+meds idea.
How it really is: Fish have immune systems, and immune systems manage pathogens. No tanks involved.
While I don't deny that some folks have used QT+meds and yet still managed to keep tangs alive, I question what shape a tang will be in at the end of such a QT. (Without getting luck involved, rough shape and still susceptible to pathogens would be my guess.)
The only point I was really trying to make is that the usual recommendation for "QT+meds" of a nearly bare tank that has been purposefully laced with toxins (ie. QT+meds) is no miracle fish cure.
Unfortunately it gets talked up as if it were a miracle cure.
And the alternatives (essentially anything without meds) are talked down as if they were the BassOMatic. As if nobody could keep fish alive before QT+meds was invented. (Witness that other reply I got?

)
Thanks to all that talking down...
Lots of folks
who do well with fish but who don't buy into the QT+meds idea end up not feeling welcome and then don't even look at the Fish Disease forum, which kinda seems to function as
an echo chamber on the ideas there. You really have to hang out away from the disease forum to get other input.
That leaves a lot of folks who take their problem directly to the Fish Disease forum to end up depending on QT+meds like that's all there is to making healthy fish.
If someone gets into that mode, they are not going to look very deeply at other aspects of their tank or their system (or where they buy their fish, etc, etc) when they already have the problems pre-solved with a miracle cure. This would be awesome if pre-solving problems like this were possible, but in reality is crucially misleading.
The problem with that is that QT+meds is fallible:
- It cannot catch or treat every potential pathogen.
- Every fish keeper cannot do the procedure 100% correctly. 100% correct is necessary.
- On top of all that, the meds themselves are toxic.
Hopefully we can agree on those points and
almost nobody actually thinks QT+meds is "perfect" or "foolproof". (There are more points, but those are the hot ones.)
This is why
healthy fish should not be subjected to QT+meds.
And why
healthy fish often don't even make it through the process when they are subjected to it.
The Problem
I suspect the problem is that some folks don't even believe in the concept of a healthy fish - only "sterile" fish that they can "make" with QT+meds.
There's a lot of science on the immune system and how a fish stays healthy though.
And I'm not aware of any science at all on making or keeping sterile fish or anything of the sort.
The Answers
The SRAC (southern regional aquaculture center) document series on aquaculture bio-security
opens with the following paragraph:
(Please recall from writing class that you end your opening paragraph with the big point the reader is supposed to take away....that point, in this case, has nothing to do with meds.
)
Biosecurity in aquaculture consists of practices that minimize the risk of introducing an infectious disease and spreading it to the animals at a facility and the risk that diseased animals or infectious agents will leave a facility and spread to other sites and to other susceptible species. These practices also reduce stress to the animals, thus making them less susceptible to disease.
Check out that and their other guides in the SRAC's section on diseases. I highly recommend reading the whole BioSecurity series as well as the other docs in that section.
A couple more quotes about QT from that doc:
Quarantine is one of the most important animal management and biosecurity measures. Quarantine is the procedure by which an individual or population is isolated, acclimated, observed and, if necessary, treated for specific diseases before its release onto the farm or for live market sale (e.g., for growout or for aquarium fish stores). The principles of quarantine apply for new fish coming into a facility, fish moving from one area or system to another within the facility, and resident fish that become diseased.
"If necessary" accompanies the only mention of meds.
Major components of quarantine include all-in-allout stocking, isolation or separation, observation and diet adjustment, and sampling and treatment.
Meds aren't even a major component of QT in their eyes.
Maybe another good read...this one from the Fisheries Service:
The Guide to Using Drugs, Biologics, and Other Chemicals in Aquaculture (Guide)
(Start with Page 16: "Best Management Practices...".)
Our rendition of QT+meds does not reduce stress. Therefore it does not reduce susceptibility to disease.
Here's where we may go the wrongest:
Sampling and treatment. Fish in quarantine should be sampled for specific diseases of concern at the beginning and end of the quarantine period and at any time that disease signs develop. Although complete necropsy evaluation of a number of specimens is best, limited sampling of more valuable specimens can be done without sacrificing the animals by examining small sections of skin, fin and gills for parasites and doing a blood culture for systemic bacterial infections. The results can then be used to improve quarantine methods and the use of drugs. Consult with a fish health professional to assist with this. Legal issues associated with drug usage should be considered before treatment.
Nobody does any of this.
Well, I've read about
@Paul B doing it, but nobody else...and he barely needs to!
BTW, a microscope costs $10 and up and there are youtube vid's on how....there isn't much excuse if we're going to be hard-core about fish disease or fish keeping.
FYI, there are germ-free animals raised in labs for use in labs, but that's a very very different thing...and kinda gross. But their existence did teach us that microbes - even potential pathogens - are actually required for proper development.