Historical inequities placed American Indians and Alaska Natives in the headlights of the oncoming Covid-19 epidemic.  Vulnerability was greatly increased by the lack of infrastructure for key services like water, housing, electricity, broadband access and educational facilities and by underlying health conditions.  Initial impacts of the virus predicted a devastating future, especially from the potential loss of elders.  Multiple agencies and organizations involved in Native American health began to mobilize but credible, coordinated data was lacking for important actions like contact tracing.  Despite these obstacles and continuing unequal losses, Tribes rose up with effective innovations through the strength of culture, trust and self-governance by asserting their sovereign rights. Through these means they developed unique and effective responses.