When I heard the news that Mayor Adams was facing federal charges, one of my first thoughts was that I hope the stress didn’t lead to a heart attack while he’s at work — because if his ambulance had to take the FDR, he might not make it alive to the hospital.
Ambulance response times in NYC are already long and getting longer. They are the highest they have been since the start of the COVID-19 pandemic, and city data shows a continued increase.
When compared to the rest of the country, the difference is staggering. A 2017 study found that while the median arrival time for EMS units in other urban areas across the U.S. was six minutes, the NYC average was 12 minutes, and up to 20 minutes for emergencies in the Bronx. To be clear, that’s just to pick a patient up; the return trip to a hospital is longer, too.
The problem isn’t planning. Ambulances are already stationed all over the city, with EMT crews on standby in various random locations. The problem is traffic, especially on so-called expressways like the FDR Drive.
A multi-lane expressway without a shoulder, the FDR runs down the East Side of Manhattan and, critically, provides access to many hospitals. It is also the main route that many commuters take into and through the city. Because of this, traffic on the FDR often comes to a standstill.
I am not the only New Yorker who has watched an ambulance, lights flashing and siren blaring, struggle to wade through the congestion on the FDR for 10 or more minutes only to move a few hundred yards. People often try to move to the side when they hear sirens, but the traffic is so thick and the lanes so narrow that the sirens only add to the chaos.
One person’s annoying gridlock is another person’s matter of life or death. A 2020 study found that rapid ambulance response times were strongly correlated to increased survival rates after a heart attack. Consider that heart disease and stroke account for 24% of all deaths before the age of 65 among New York City adults, and it’s clear that this is a public health concern that affects New Yorkers across all socioeconomic statuses.
NYC is not the only city to struggle with congested roadways and heavy traffic. One solution that has worked for urban centers like Abu Dhabi is emergency service lanes specifically dedicated to police cars, fire trucks, and ambulances. These could buy someone suffering from a medical emergency critical minutes and would likely save lives. Creating a limited access lane specifically for emergency services would allow ambulances to move more freely and decrease the door-to-hospital time for many patients.
A more dramatic solution would be congestion pricing. The plan will cause commuters to avoid lower Manhattan or pay tolls. While it would likely divert traffic to West Side Highway and the FDR, the plan would also reduce traffic on local streets and possibly provide ambulances quicker routes to hospitals.
For anyone questioning the benefits of congestion pricing, London offers a compelling case. Since implementing the policy more than 20 years ago, the city has reduced traffic congestion by 30%. Quicker travel times likely mean faster ambulance response, a benefit we cannot overlook when it comes to public safety.
The congestion pricing plan would also drastically increase bus lanes, a move that is also being embraced in D.C. Through its Clear Lanes Initiative, D.C. is creating new bus lanes that are limited to buses and emergency service vehicles. By restricting passenger cars from driving in bus lanes — and enforcing these rules with cameras — D.C. hopes to improve transit times for buses and emergency services alike.
Yes, NYC already has some bus lanes that can be used by emergency services, but these lanes are not well respected, are only during peak transit hours, and could be much better enforced (there have been attempts to do so). As a result, bus lanes are often indistinguishable from regular lanes when it comes to traffic density. By limiting who can travel via bus lanes, increasing enforcement of traffic laws via camera monitoring, NYC could see a massive decrease in emergency service response and bus transit times.
Options exist, and all of them are better than the status quo. And trust me, this isn’t something you want to be pondering from the back of a stalled ambulance.
NYC is a fast-moving city. Our ambulances should be moving, too.
Bonner is an emergency medicine physician in NYC and a public voices fellow with The OpEd Project through Yale University.
