extremely.
Ich is not a disease, but a parasite: some of the pustules will erupt, the parasite will head for the sandbed, and go through a life cycle stage there before swimming up and infecting another fish, to then drop off, etc.
Fish usually die from general weakness, or ich infesting the blood-rich gills and robbing the fish of oxygen. A fish with flaring gills is sick...and may show no bumps on body.
The two treatments are hyposalinity in qt [your tank can't take this] of 1.009, which kills microorganisms before it kills your fish; and copper, via medication, which kills microorganisms before it kills your fish.
Treat all fish that were exposed, and keep them in qt after treatment, while tank goes fishless for 6-8 weeks...the parasite will starve to death and not be able to reproduce. Sorta like a bad flea infestation, though there IS no safe treatment for your tank itself: just starvation.
From one fish it can go through a tank like fire through dry grass---killing just about every fish in there. Particularly susceptible, tangs, angels, clowns, and rabbitfish.