## 3 Communication Protocols, and IoT Challenges for Pandemic Control
To summarize, the communication protocol that can be integrated in the patient monitoring architecture has to meet the following characteristics:  
* Ensure a long communication distance and a high-level of performance within a city-specific architecture;
* Have the possibility to integrate wireless sensors distributed over a large geographical area;
* Be suitable for non-LoS (line of sight) urban specific conditions;
* Have resistance to radio interference;
* Confirm the technology is already available and implemented by many municipalities;
* Facilitate massive deployment within a low complexity, communication architecture, with a short implementation time;
* Contribute to the active monitoring of the patient's health condition;
* Have low-power consumption to allow the integration in a wearable multi-sensor smart device;
* Provide a high level of performance as a cost-effective solution. From the previously presented information we can conclude that the LoRaWAN communication protocol ensures a high level of performance and can be integrated in development of the patient monitoring system. LoRaWAN is a communication protocol for media access control (MAC) designed for IoT applications and wide area networks that use LoRa modulation. LoRa modulation uses orthogonal spreading factors (SF) for individual wireless nodes to increase the communication range by reducing the data rate. LoRa modulation uses communication channels with fixed bandwidths of 125 kHz or 250 kHz for uplink channels and 500 kHz for downlink radio channels [24]. The SF can be varied from 7 to 12. The higher the SF, the higher the value of the packet time on air (ToA) will be, lowering the data rate and increasing the communication range by lowering the sensitivity level of the radio transceiver, from \(-123\) dBm for using SF7 to \(-137\) dBm when SF12 is used, respectively [25]. Thus, LoRa wireless nodes that are located in the proximity of the gateway will use SF7 and nodes located at longer distances will use SF12. The SF allocation is defined by the LoRaWAN specifications [26] in an adaptive data rate (ADR) algorithm where the SF is increased if the communication link budget is high meanwhile the SF is reduced if the communication link budget is low. The ADR and SF particularity of the LoRaWAN communication protocol offers a real advantage in urban environmental conditions, achieving long communication distances and is ideal for the patient monitoring system. The increase in COVID-19 infected people brought along with it a general overload of the medical system. In many regions the hospitals are overwhelmed with severe cases, leaving no room for the mild cases. Taking this into consideration, recently we have seen great interest in remote patient monitoring devices and in telemedicine, as is discussed in the previous section. In the scientific literature, multiple approaches are presented for remote patient monitoring, each one with unique features, advantages or disadvantages that must be overcome in future iterations. [PERSON] et al. [27] present a device for COVID-19 prevention that monitors and records the daily activity of a patient. The main monitored parameters are the movement of the body recorded with a 3-axis accelerometer and the body temperature recorded with a CMOS analog temperature sensor. The device is attached to the subject's wrist with two elastic bands to ensure constant contact of the temperature sensor. The data are transmitted to a PC using a BLE (Bluetooth low energy) module. The system also integrates an AI approach as to detect patterns of human activities. One disadvantage of the system is the short range of the communication transceiver, covering only approximately 10 m. The developed architecture is not scalable due to the BLE integration thus, long-distance communication was not considered. [PERSON] et al. [28] propose a patient quarantine monitoring system based on multiple sensors approach.