[1]: https://www.maltron.com/store/p11/Maltron_L89_dual_hand_full...
I haven't used a Kinesis, so can't compare to it (though Kinesis is supposed to have copied their design, so I guess it's very similar.)
And then I hit them with my middle finger instead, or rather smash them as it requires the whole hand to move slightly.
So in my case does not affect speed or comfort (not a frequent VIM user etc)
But if I only had two thumb buttons I would be ok.
A couple of months back I built another prototype, this time with a 6x4 + 4 layout. I'm still not loving the layout, four keys is too much for the thumb cluster and I'm looking at dropping down to three. Ironically I've already setup my layout so it almost only uses 6x3 + 3 (I use the top row for non-typing keys like F1-F12), and in effect reinvented the Corne that I started out with...
The rest I just use for miscellaneous other uses, like pgup/pgdn and inverted-T arrow keys. It's not for use with the thumb, but it's just a handy place to put keys you'd have to move your hand for anyway.