US companies are "more negative than they've been in a long time" about doing business in China, according to the president of the American Chamber of Commerce in China (AmCham China).
As tensions continue to grow between the world's two biggest economies, Michael Hart says that the rivalry has "made business very challenging".
The governments of President Xi and President Biden have been disagreeing on what seems like an ever-increasing number of issues; ranging from Ukraine, to coronavirus, and Taiwan, to Tiktok, and semiconductors.
That is reflected in AmCham China's latest annual survey of its more than 900 members. For the first time it shows that a majority, 55%, no longer regard China as a top-three investment priority - a place where they should spend money to grow their business.
The number who see the "uncertainty of bilateral relations" as their leading challenge in China has risen 10% in the last year to 66%. At the same time, the number who think China has become less welcoming to foreign companies has grown to 49%.
It's now five years since then US President Donald Trump imposed tariffs on $60bn (£49bn) of Chinese goods, as he stepped up his trade war over "unfair trade practices" including intellectual property theft and the trade deficit.
China followed through on its promise to retaliate with tariffs of its own.
Relations built on trade
AmCham China members include some of the US's most successful companies such as Nike, Intel, Pfizer and Coca-Cola.
The latter was the first US consumer business to sell its products in communist China after then President Deng Xiaoping opened the country up to foreign companies in December 1978. Ever since then trade has been at the heart of the relationship.
Corporate pessimism over the current state of the US-China relationship reflects a tumultuous few years, according to Mr Hart.
"Companies are just really tired after three years of Covid," he adds, also highlighting a number of other issues. These include travel becoming more difficult, rising labour costs, executives who are "just not willing" to take up assignments in China, political pressure, and China becoming a less predictable place in which to do business.
Despite all those difficulties, the numbers show trade between the two countries hit a record high of $690.6bn last year.
This reflection of their mutual dependence has implications for the health of the entire global economy. That is according to Eswar Prasad, who is a professor of global trade policy at Cornell University, and former head of the International Monetary Fund's China Division.
