@Dragonsreef
From the other perspective.
Yes, it is very hard to tell the difference between velvet and ich. The common names don't help.
For the record I don't use special food to correct problems because I see disease as endemic to some problem in my (the) system. I have learned over the years to ensure that the system is diverse, balanced and stable. I will get into that further down.
I have had to think back to remember when I have seen this disease. I also went over to humble fishe's site to see what he says because he seems interested in this stuff. Here is what I found over there:
https://humble.fish/marine-velvet/
This caught my eye. I think this is the key to diagnosis. The count thing may be as well but definitely this.
You need to move with a sense of urgency when a fish has velvet. This is not the same as dealing with ich. A fish with velvet may have days or just hours to live without prompt treatment.
The article is pretty grim.
Yes I have seen that. Honestly once it is going stopping it is pretty much impossible. I definitely understand how it strikes fear into reefers. It also speaks to pre-empting it before it gets a foothold.
Ok, how do I deal with it without using medication and QT to pre-empt it?
First off fish selection. If the fish has spots I don't think anyone is going to take the chance. I am dumb and a sucker for the creatures and yes I would be stupid enough to try. Honestly though, I want the LFS that is crappy enough to sport a fish like this for sale to eat it. I hate that the fish will die but I want the store to feel the pain financially so that they will try to deal with this or at the very least not put it up for sale. Trust me this does take a toll on the stores that won't deal with it. Good! Most stores have felt the pain of this disease in their systems. Because of this they take extrodinary precautions to deal with it. Copper, quarantine, UVs, hyposalinity ... For many people this is their first line of defense against velvet and disease in general. Essentially they find good LFSs to buy their creatures from, let the LFS eat the loss. This is very Darwinian as well it should be. Even this though can fail and the disease can slip through. Many still use this as an argument for QT. Legit, because failure with this disease is catastrophic. In a lot of cases I can use this but honestly I am not a fan of LFSs. It is hard to find good ones and eventually I am disappointed. It's not to say I will walk into a LFS and buy a sick fish it is just to say that sometimes there are other factors at play. In my personal case because of where I live and some other factors I don't have easy access to a quality LFS. I order online, sight unseen. I could order from QT'ed sites but I feel comfortable enough with my skillz to not do that. That said crappy retailers are crappy retailers and if I don't like my choices I will buy QT just to not have to fight with poor quality creatures. Just remember you can't fix stupid, and I definitely don't want to pay for it.
Second gas exchange. I used to mistakenly believe that oxygen is what is needed for the fish. Especially the sick ones and with velvet they swim in the current because they can't breathe. Oxygen is indeed important but the amount of atmospheric oxygen that is available is pretty high so getting oxygen in the tank is relatively easy. It is however really important to new fish that might be dealing with stress related diseases that the oxygen be as high as it can be. dang near every parasite attacks fishes gills and this totally impedes their ability to breathe. Therefore it is really important to have high oxygen. There is however another really important factor to gas exchange. This is my speculation but it is formed over many many years. You need really good gas exchange because you need to outgas CO2. IMO this is really really really important. Having balance with atmospheric air conditions is paramount IMO to successfully fighting disease. A fish that is fighting for air because of parasites doesn't need to have strikes against it because the aquarist didn't deal with his/her gas exchange problems. Deal with gas exchange at the tank level, deal with gas exchange at the room level. I have spent a ton of time and energy understanding gas exchange problems. FWIW ... I got this idea by watching the wave action in the ocean. Didn't seem important then, much later I realized how very important it is.
Tank maturity. Tanks definitely aren't the ocean and really don't have dilution in their favor, but they do have something that ocean doesn't have ... density. A mature tank isn't going eat all of the free swimmers but it is definitely going to put a dent in them, especially if you have a lot of filter feeders. Filter feeders are indiscriminate and if it is floating in the water column it can potentially be food. This is going to help cut down the load. No science here and perhaps I am wrong but this seems to be a likely reason. Tank maturity could also be helpful because of a reduction in ...
Stress. Fish need to feel safe. It takes many (me included) many years to understand when a fish is stressed. The more skilled you are at this observational skill the more quickly you can see stress. Also this skill will help with spotting low level stressors that a fish might be experiencing. For example, I have a Pakstani Butterfly. He was new and after the initial acclimation about 3 months he was still stressed. I kept scratching my head as to why he was stressed everything seemed in order, but my experience told me otherwise. I pondered it for almost a week until it dawned on me. I took a flash light and looked into the tank at about midnight. Sure enough, idiot fish wasn't sleeping in the rockwork he is was out in the open and the light pollution from all of my equipment was keeping him up. Argghhhh so I started putting a sheet around the aqarium to black it out at night. It took a month for him to calm down and the stressor went away. Experience is the only way to spot this.
Food. Fish need healthy nutrious food. This is no easy task and getting them to accept it can be a real chore. I used to just do mysis and flake. Paul B. has gotten me on to white worms. Live is definitely better. I am now bold enough to cut up grubs from my compost and let the fish eat them. They also get bugs that fly to close to the sun or in this case my light. You need healthy nutrious food for the fish. If you don't have this then they will have low level stressors. This won't kill them but once again if a something nasty comes you want to the fish to have every chance available to it.
Stocking levels. This is the one that I think most people violate the most. Every tank has it's limit. Much like a credit card it isn't wise to run to the limit, but the temptation often suckers people in and then they get a disease spiral. Just like a credit card this rarely comes at an opportune time and is like a freight train to stop and when it does the destruction is almost always catastrophic. I like my stocking levels like I like my credit card very very very low, and easily with in my reach of dealing with. Because when catastophe comes it is rarely fun to have your pants around your ankles. Just remember carrying a high credit card balance is fine until you lose your job.
All of these things work in concert are how I ensure that my creatures are happy and with their happiness and by extension their health, my happiness.
If this sounds harder than QT then you understand.
My 2 cents.