In Alaska, where the Indigenous population has been ravaged by global disease outbreaks for generations, the pandemic has killed Alaska Natives at quadruple the rate of white residents.

The virus has taken hold in remote communities, setting up an urgent race between infections and vaccinations during a season in which weather can limit travel, the sun may only wink above the horizon, and large, multigenerational families are crowded indoors.

When the pandemic began a year ago, Alaska’s isolation was an asset that provided villages an opportunity to set up lockdowns, testing requirements and controls on travel.

But as the virus has slowly seeped across the state, the rising infections have demonstrated how quickly isolation can turn into a liability. In Pilot Station, a 37-year-old man died after weather prevented a medevac plane from reaching him. The virus has raged in some communities that have minimal sanitation, in some cases infecting more than 60 percent of residents.

Yet thanks to the steady supply of vaccines available to Native Alaska tribes and a sprawling delivery effort involving bush planes, boats, sleds and snowmobiles, 16 percent of the population has received a second dose of the vaccine, the highest in the nation. One of the regional operations, Operation Togo, harks back to the grueling 1925 sled dog run that rushed diphtheria antitoxin across the state to an outbreak in Nome.

The villages also have resources they lacked a century ago, when the 1918 flu wiped out more than half of some communities. A network of tribal health aides provide frontline health care and critical testing, treatment and telemedicine links with faraway hospitals — a network being considered for replication in the Lower 48.

But with the vaccine, there are extra challenges: Health crews must coordinate flights out to villages and arrange for someone to pick them up at the runway by vehicle or snowmobile. They need to make sure someone has started up the wood stoves to warm up the tribal halls where shots will be administered.

One team recently landed in a village as the temperature hit 61 below.