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If you use a mod that allows you to start in Louisville it starts off just like any other location.
But yeah, it is infested from the start.
That would be epic. I truly wish the game NPCs would allow for that kind of passive activity in map areas but I suspect it would be quite a while before we see something that advanced.
In LV base itself you can see in the quarantined houses that have had their stuff removed and out put outside that a zombie in one house was tied to a medical table. So there will probably just be a few npc you can go and keep alive.
They make you get a job to work a hot dog stand in the park for a week.