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Maybe one reading for this ending is Hinako represents young people rejecting old traditions like arranged fox god marriages and leaving the rural villages. The process ends with the villages empty, the traditions forgotten (sped up by toxic gas)

I've suspected for a while Kotoyuki was a creep who had an obsessive crush on Hinako after she saved him from the fox and years later used his family's money to basically buy her in marriage by paying off her father's debt. The evidence is mounting

Congrats on becoming hokage, Reine

And the so called "real world" is hinako seeing how she was when she was younger

It's not tha shu can cross into the "spiritual world" , it's just repesentative of the actual world through this mystical lense