The Life-or-Death Consequences of Killing Congestion Pricing

Two weeks ago, as the Adams administration was beginning its implosion, New York City’s health commissioner, Dr. Ashwin Vasan, announced that he would step down in January. Although his resignation did not suggest any entanglement with the federal investigations surrounding Eric Adams — or the news that the city’s former Covid czar, Jay Varma, was “just being naked with friends” when he invited about 10 people to a hotel room during the height of the pandemic — it reveals another sinkhole in the ground of functional governance.

Among his accomplishments, Dr. Vasan established HealthyNYC, an initiative to extend the life expectancy of New Yorkers to 83 by the end of the decade, in part by decreasing the number of deaths related to heart disease and diabetes by 5 percent. While, on the face of it, a modest goal, it inevitably bumps up against the realities of an overburdened emergency-care system that further reveals the deficiencies of the city’s transportation policy in all of its life-or-death consequence.

The release of the annual Mayor’s Management Report last month pointed to two convergent and unsettling trends. The document, a 558-page evaluation of how well, or not, key city agencies are serving New Yorkers, indicated both a 5 percent increase in life-threatening emergency calls between the fiscal years 2023 and 2024 and a slower response time in handling them.

During that same period, dispatch and travel times for both ambulances and Fire Department vehicles during dire medical emergencies increased by 20 seconds, for an average response time of 7 minutes 23 seconds. Every minute someone having a heart attack goes without CPR reduces the chance of survival by 10 percent.

If we go back further, the relationship between traffic patterns and emergency-response times becomes even more startling. Last month, State Senator Brad Hoylman-Sigal and the traffic engineer Sam Schwartz issued a report titled “Speed Kills,” inspired by an experience the senator had in which he waited with a writhing stranger in Chelsea for 37 minutes before emergency medical technicians arrived. The report indicated not only that New York was the most congested major city in the world but also that over the past decade, E.M.S. response times to life-threatening situations had increased by 29 percent; for Fire Department vehicles tending to medical emergencies, the lag was up by 72 percent.

To put it more emphatically, if you are having a cardiac event in a 16th-floor apartment in a busy part of Manhattan and you don’t find yourself in the company of someone who can competently administer CPR, you will very, very likely die — more likely than if you lived in a ranch house in, for instance, New London, Conn. Over the past year, the Fire Department responded to 30,038 reports of cardiac arrest or choking; only 20 percent of the cardiac patients were revived.