I’ve never been concerned about ich as it was always easy to treat until I dealt with a particularly resistant and virulent strain. My usual regimen is heat, salt, and water changes and if that doesn’t work, I turn to meds.
I once added a chubby pleco into a large colony of zebra plecos and within days they got ich. I followed all the usual steps but it kept getting worse. Nothing worked...including multiple OTC medications. After losing one of the zebras, i got desperate and added several oversized heaters in the tank and cranked them up. When the tank got up to 96 degrees, I finally began to see improvement and eradication. I was amazed the fish survived the temps but they looked so much better and made a full recovery.
I’ve kept fish for decades and that experience shocked me. I never knew there were different strains of ich until then and don’t take it lightly anymore