US factory activity shrank in November by the most in four months as orders weakened, indicating manufacturers are struggling to break free from an extended period of malaise.

The Institute for Supply Management’s manufacturing index eased 0.5 point to 48.2, according to data released Monday. The measure has been below 50, which indicates contraction, for nine straight months.

The survey suggests the nation’s manufacturing base remains bogged down by trade policy uncertainty and elevated production costs. The ISM index of prices paid for materials picked up for the first time in five months and is about 8 points higher than a year ago.

Customer demand has largely been uninspiring as well. Orders contracted in November at the fastest pace since July, while backlogs shrank by the most in

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