Based on the given information, settler diarrhoe is not to work anymore.
Sure, it will make sense to build the very first cities very fast, but later on this strategy should just be ruining you, as the few initial cities will not be able to support you. In turn this means that any additional city will get lost in the one way or the other.
It seems to be vital to determine the right places for your cities, thus making strategies as the OCP (optimal city placement) obsolete.
If this works as intended, it will be a good thing.
How easy it will be to build up a big empire, is yet unknown to us, although I am pretty sure that big empires still are possible. If they aren't this will be one of the first things (after unit size) which I will try to mod.