When considering the likely outcome of whatever action Medium have taken, you have to consider their likely competence ... and, the first question anyone (even if they have absolutely no technical knowledge or experience upon which to draw) should be asking themselves about this whole affair is: "If it's taken them this long to get around to exercising such a core competency as identifying fake accounts ... how likely is it that they have done so with any competence?"
In the (going on for) five years I have been here, on Medium, the impression I have got is that it is maintained by people who have ... if not simply no technical knowhow ... very little real knowledge or understanding of ergonomics, UI, UX or Design indeed; sufficiently little, in fact, for my still not being inspired to open a member account, because I don't trust them to secure my data against hackers — not even by outsourcing it ... because, I wouldn't trust them to have anyone technically proficient enough to know when the service offered by a third-party consisted of poor practice itself.
My suspicion is that ... even if they have cleaned up a lot of fake accounts (spammers, sock-puppets, etc.) ... what they've probably done is (also) run an algorithm and deleted accounts that haven't been active in a long time — and, whilst that's not necessarily detrimental in terms of our knowing how many active followers we have, it wouldn't be a result of their having deleted all the fake followers, just some (at least) fake faccounts and a lot of followers who have since departed Medium but not bothered to delete their accounts (which wouldn't be the same thing at all).
As a result, there is, moreover, a further possibility that a not altogether inconsiderable percentage of those lost followers weren't actually fake but simply people who don't post 'stories' of their own, nor reply to anyone, but simply read things they're interested in — not everyone is an extrovert and many people just 'lurk' as it were.
I'd want to know exactly what the selection criteria were for deletion myself and, furthermore, what the deletion algorithm was, before I decided to wax lyrical about the favour we have all (supposedly) been done — as much as anything else, how much of the announcement was PR to cover up the fact that, ...rather than do the job properly, with finesse, for the benefit of authors ... it was really an exercise in Medium saving itself costs by simply removing those that don't merit (in their eyes) the technical (and, therefore, financial) overhead incurred by storing data for those accounts?
Colour me cynical, if you want, but I've been in this game for a long time now and I have my suspicions about this particular exercise.
</just a thought>