When it comes to vehicles on our roads, we all know that speed kills. But not just in the way that you are thinking. Extremely slow speeds, like we are seeing in New York City today and over the past few years, can seriously harm and even kill people, businesses, and neighborhoods. Congestion in New York is worse than it’s ever been, and according to INRIX, a private transportation data analytics firm, the worst in the world!  Plenty of studies have been done on how high speeds kill. There are mathematical curves relating severity of crashes directly with rising speeds. But little research has been done to show how very slow speeds can kill as well. We set out to examine this issue by comparing data from 2014 to 2024. The results were astounding According to data provided by the New York City Department of Transportation, for the 12 months ending June 30th, i.e. FY 2024, Midtown speeds averaged 4.8 miles/hour. All of Manhattan south of Central Park, also known as the Central Business District (CBD), the very area in which congestion pricing was set to take effect, has seen speeds drop below 7 mph for the first time since records were kept. A decade ago, Midtown and CBD speeds were nearly 20% higher at 5.7 mph and 8.2 mph respectively.  The most obvious way gridlock can affect our physical health is by increasing the amount of time it takes for emergency vehicles to respond to health emergencies, fires, and criminal reports. The Mayor’s Management Report, just recently released, showed that response times in most categories worsened over the past year and we decided to take a deeper look for a longer time period- a decade. To supplement the mayor’s report, and because we know that travel times worsen throughout the year, we also included data from the summer of 2024. We compared NYC 911 End-to-End Detail data from July 2024 with July 2014 as provided by NYC.gov. website. The numbers were clear. Response times for all three indicators, medical, crime and fires, have risen significantly over the past decade.  EMS life-threatening response times increased from 9.6 minutes to 12.4 minutes, an increase of 29% and 2.8 minutes. Non-life-threatening EMS response times more than doubled from 8.3 minutes to 23.3 minutes; 15 more minutes of suffering while waiting for an ambulance.  Medical professionals will tell you, to no one’s surprise, there is a direct relationship between response time and outcomes, including rates of survival. For example, for every minute of delay in a stroke patient nearly 2 million brain cells die which can result in severe disabilities, such as loss of speech, paralysis, or even death. With cardiac arrest patients, the odds of survival drop by 10% for each minute of delay.  According to the union president for FDNY EMTs, Oren Barzilay, in an interview with Spectrum News NY1, “Clinical death begins after four minutes. Biological death begins after six minutes. So, if we’re getting there in nine minutes, your chance of surviving a heart attack or going into cardiac arrest are slim to none.” That may sound like hyperbole, but study after study and doctor after doctor all agree that “Time is Brain” for stroke victims and “Time is Muscle” for heart attacks.  Pediatric emergency department doctors are also sounding the alarm, as Dr. Mark Hanna, of Columbia University Irving Medical Center told us, “time to intervention” is directly related to saving lives especially with children suffering from anaphylaxis or opioid overdose. He told us of just such a case where he drove with lights and sirens weaving through traffic to get to a teenage boy suffering from anaphylaxis. But, by the time he got there the boy, was in cardiac arrest and did not survive. “I think about him often and to this day believe we could have saved him if we had gotten there sooner,” Hanna told us. Dr. David Schaeffer, an ER physician we interviewed, also pointed out the need for speed for non-obvious life-threatening injuries, say a broken leg after getting hit by a car, where response times have increased by 10 minutes. Unseen could be a torn artery where the end result “could be loss of a limb or damage to a critical organ,” said Schaeffer. It’s not just ambulances that are feeling the effects of slow speeds, other emergency response times have suffered as well. Response times for NYPD Critical, which includes shootings, robberies and burglaries, and is the most urgent category reported, jumped from 7.9 minutes to 9.7 minutes, an increase of nearly 2 minutes. Two minutes, while a crime is in progress, can seem like an eternity. It can be the difference between life and death. The increased response times are not due to an increase in crimes being reported, those numbers are actually down. The New York Post reported that in 1997, with about twice as many major crimes reported, response time was a bit more than 5 minutes, nearly half of today’s rate. City Hall spokesperson Liz Garcia said the increase “is likely driven, in large part, by increased traffic congestion across the boroughs.” In the past decade, NYPD response to serious incidents jumped by 4 minutes and non-critical responses doubled to more than a half-hour! FDNY response times to structural fires increased by about half a minute from 4.7 minutes to 5.2 minutes over the last decade. Response times for non-structural fires increased by seven-tenths of a minute. Most troubling, FDNY Medical Emergency response times jumped by 70%, increasing from 8.3 minutes to 14.3 minutes.  Any New Yorker can tell you of the schadenfreude they feel listening to FDNY ambulance sirens wailing in stuck traffic, just being glad it’s not them in the back. I (Brad) witnessed this firsthand in Chelsea back in June when I came upon a man writhing in pain on the sidewalk; it took 37 minutes for an ambulance to arrive. For each of those 37 excruciating minutes, I felt a combination of anxiety, fear, and hopelessness that no New Yorker should ever have to feel when looking for help in an emergency. Fortunately, an ambulance did eventually arrive, and the first responders did a wonderful job taking care of the man, who I am pleased to say has since made a full recovery. To be very clear, we are in no way blaming our first responders, who do a fantastic job keeping us safe, for these delays but the situation truly underscored the impact that congestion is having on our emergency vehicles and on our first responders’ ability do their jobs most effectively While there may be additional explanations beyond traffic congestion for these delayed response times, we find the decline in emergency vehicle response time over the past decade very clearly correlates with traffic speeds in Manhattan’s Central Business District and city-wide. Fortunately, there is already a solution in the books to address this problem, congestion pricing. Congestion pricing would help to significantly reduce congestion within and around the Central Business District, especially those dense neighborhoods on the fringes of the CBD including the Upper East and West Sides of Manhattan as well as Downtown Brooklyn and Long Island City.  We write this on the cusp of the UN General Assembly high-level debate which starts this week. More than 100 world leaders will be gathering in New York City and NYC DOT data shows that last year, during peak UN week, average Midtown speeds fell to just over 3 mph. To give you a frame of reference: for someone with an emergency at say Penn Station, just two miles from NYU Langone’s Emergency Department, it would take 40 minutes to get there. At 4 mph it would take 30 minutes — 10 minutes less; at 5 mph it would be 24 minutes — 14 minutes less! The differences are grave both figuratively and, in some cases, literally. Every minute, and every second, matters when it comes to emergency response times. We cannot allow congestion to delay these response times any longer. So, please take care of yourself during UN week and beyond especially if you work, live or play in Midtown. And contact your elected officials to let them know that we need congestion pricing, and we need it now. It’s a matter of life and death! Hoylman-Sigal represents the West Side of Manhattan in the state Senate. Schwartz is a former NYC traffic commissioner.