A great deal of ATC relies on automation, such as systems like ASDE-X, which is used at LGA. ASDE-X uses radar and vehicle transponders (among other things) to detect collision hazards on the ground. Unfortunately ASDE-X only works if every vehicle has a transponder.
ASDE-X is an automated system that alerts tower and ground controllers to collision hazards on the airport surface. A transponder is a device that either responds to radar pings or continuously broadcasts the vehicle's position. They are mandatory equipment for aircraft, and at most large airports they're required for all ground vehicles too. The two systems work together.
If the truck had had a transponder, ASDE-X would've automatically alerted the controller who was working that night. So there's another link in the chain, in addition to the staffing issue and the failure to visually clear the runway.
There is no "the" issue in airline accidents. There are always multiple factors, and all of them had to happen in order for the accident to occur.
Understaffing is absolutely a factor. Had tower and ground not been combined, the erroneous clearance probably wouldn't have been issued.
The ARFF truck not complying with the stop instruction is absolutely a factor. Had they heard and complied, the accident wouldn't have happened.
And there are likely additional factors that will come out in the investigation.
I recommend reading some final aviation accident reports from the NTSB to learn more about how these investigations proceed and what kinds of conclusions and recommendations they include.
Any system that requires perfect performance from any one human will fail.
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