I question the notion that there are PWME with no viral activity. We know that the testing is far from perfect, that analysis by doctors of the test results is often poor, and that there are a lot of viruses that don't get tested for. Very few PWME have been adequately tested or evaluated. Symptoms of ME/CFS (I'm excluding for the moment non-PEM chronic fatigue) tend to align with the notion of a pathogen involvement. I agree it's possible that the primary pathogen might be bacterial, but even then persistent or severe bacterial infections often lead to reactivation of or susceptibility to opportunistic viral infections. When I see a person with clear CCC or ICC ME/CFS who has 1) had testing for the major known pathogens seen in ME/CFS, 2) had those tests evaluated by a doctor knowledgeable about pathogens in ME/CFS, 3) had sufficient immune testing to identify the effects of viral infection (known or unknown pathogen) and STILL shows no sign of viral activity, then I'll give more credence than I do now to the notion of patients with no viral activity. ETA: I'll also fall down flat in astonishment that any PWME actually got all the necessary testing and evaluation to completely rule out virus activity.