Why I Don't Blame Anyone For Playing Tank Ekko.

Ekko is a Skirmisher, or at least he is intended to be a skirmisher. He does have some very minor poke with his Q, but in order to deal a bulk of his damage, he must engage in melee combat.

Being effective as a skirmisher means you have to either completely erase your opponent immediately and be able to reliably escape without being turned on (so basically an assassin), sustain yourself through life regain of any method, or .. by simply being tanky.

The assassin method is more fun, but significantly more risky. You MUST be ahead or you will be feeding.

I would prefer the sustain method, and I believe Riot would as well, however with the HUGE nerf of spellvamp to near extinction, AP Skirmishers have very few options for sustain. The best method he has to continue to use a sustainable build is to buy Hextech Gunblade for the omni-vamp or any item that builds from Catalyst for the Aeons for the Eternity passive.

Eternity, ... just doesn't work. It isn't designed for skirmishers because it doesn't return enough health, which is fine for ranged mages because they aren't always in direct combat. However, Ekko's mana costs are designed to be low because he needs to be able to use his abilities in a rapid succession, and even then, his cooldowns are not that low. Eternity only converts 20% of mana consumed into health. His most expensive ability is his ultimate, costing 100 mana, only grants 20 health, which does not even reach Eternity's cap of 25 health per ability.

Gunblade is a hybrid item, which ultimately will work, but just doesn't feel good in every situation.

So ultimately, THE BEST option with any sense of reliability and diversity is to go for the tank options.

I think the only way for them to really fix this would be to build some form of sustain into his kit. I don't know if this will eliminate the tank Ekko problem, but it would make offensive options more appealing.