A fish can die from ich without you ever seeing direct signs of the parasite, ich loves the gills. The white spots are just evidence of the parasite burrowing into the fish, not the actual parasite. The worst thing about this parasite is that the whole tank has it, not just a fish that shows spots. I'd read Snorvich's ich stickies at the top of the disease column. Knowing the ich life cycle is vital info for all of us.