I’ve been reading about people’s varying opinions regarding whether a tank always has ich or not. If the assumption is that your tank always has ich or some other type of disease potentially looming, what does a person do when introducing new fish to the tank who will undoubtedly be stressed and therefore have lower immunity? Even if these fish are quarantined, being caught and transferred is stressful. Does that mean that the tank is always carrying the potential for disaster every time a change, especially to livestock, is made?
When I start a tank, I 100% do not have any diseases. I know this because I give my LR a bath in Muriatic acid and bleach. Both to kill any unwanted pests, and to get rid of any P04 that may have leached into the rock from the prior tank. I know at least at this stage I have zero pests, zero good or bad bacteria. I am starting from scratch.
From here you have to seed the tank. You can buy bacteria like Dr. Tim's, which I have used, but you also want to seed your LR with a couple pounds from various other tanks to get some diversity in your tank. IF you do this, you can setup a holding tank (separate from your main system), and keep the rock in there with a powerhead and heater for 72 days. This 99.9% ensures that anything on there (disease wise) will die.
From here, you buy fish and a CUC. Now for fish, I 100% QT and treat all fish like they have at least ICH and Brook, since almost all of them from the store do or at least were exposed to it while in the holding tanks. Again, 72 days, and you are pretty confident that you have removed all the diseases once they are added to your tank.
From here, I would say that you have a pretty likely chance that your tank is disease free. But where it gets risky is when you start to add snails, crabs, chaeto, macro algae or corals. Do you QT? Do you hold them in another tank, inspect and then add? Personally, I do not QT my CUC, chaeto or macro algae. I honestly just don't have the time. Technically, if you want to me 100% safe, you QT ALL wet items that are being added to your tank and ensure NO water from the store gets into your main system. Again, do you QT your chaeto? I don't.
There is no 100% proof of anything really. People have gotten ICH simply from cross contaminating their net with store water. It can be that easy. I QT all fish and corals because they have the highest chances of carrying diseases. From there, I weight the risk and odds from when I add my other stuff. You have to be realistic in your expectations for if its viable for treating EVERYTHING wet. For me, its not, but again, there is some risk that when adding stuff that haven't been in QT, unwanted diseases can come as well.