US companies operating in China were having an increasingly tough time last year as slowing economic growth and trade tensions squeezed profits before the coronavirus outbreak added to their concerns, a business survey showed on Tuesday.

Over a fifth of the 372 members of the American Chamber of Commerce who answered the survey saw a drop in revenue in 2019, compared with 7% in 2017.

Just over 60% described their operations as profitable, the lowest proportion in almost two decades, according to the survey, which was conducted last year.

“The fight against COVID-19, ongoing bilateral negotiations,and a slowing Chinese economy make for challenging business conditions,” said Greg Gilligan, the chairman of the chamber, in a statement released with the survey.

The United States and China signed a Phase 1 trade deal in January, easing tensions in a protracted trade war between the world’s two biggest economies, but hopes of a quick economic recovery have been dashed by the coronavirus outbreak.

The outbreak began in the central Chinese city of Wuhan late last year, causing massive disruptions to business operations, supply chains and economic activity.

The outbreak has killed more than 3,000 people and infected over 80,000 in China alone.

Over a third of respondents said they were delaying or might reduce their investments in China in 2020.

Nearly a quarter of companies said they did not expect their markets to grow this year.

Some 10% of respondents to an earlier February survey by the chamber said they were losing at least half a million yuan a day from the virus disruptions.

“Our member companies are in varying stages of resumption of productivity. So operations are mostly north of say 50% incapacity, some are as high as you know 80%. This is somewhat anecdotal,” Gilligan told a news conference on Tuesday.