The only particularly bad case I've found is v/w/z being right next to one another, which can be annoying. Still, I think I've won out overall. I spend a lot more time typing text than I do invoking keyboard shortcuts.

Regarding games, switching keyboard layouts in Windows 10/11 is thankfully super easy. (And some games do get it right, and the bindings go by physical position, so they just fall into place - though personally I've never liked this, because I don't really know where any of the Dvorak keys are individually, for non-text purposes. I'd rather switch to QWERTY and then I can look at the labels on the keys to figure out where to put my fingers.)