Is the world really empty or is it just that way because video game?

I never really noticed or thought about this before but there's quite a bit of stuff in the DLC that has me questioning whether or not the game itself matches the lore in the sense that there are plenty of people who are alive and well (Melina's line when urging you not to seek the Flame of Frenzy also states that life still flourishes and that births still happen), they're just not shown in game because Fromsoft doesn't think they can do bustling, living cities well.

What do you think? Are the few NPCs we meet all that's left in the world or are they just representative of a larger picture we don't see due to the fact it's a game?