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When they dropped in Switzerland the Republic of Irelands hopes of qualifying automatically for Euro 2020 remainder on next months home game with Denmark.
Edimilson Fernandes and Haris Seferovic hit on the aims although victory would have booked the Irishs location.
Qualification will be secured by A triumph on the Danes on 18 November from Group D.
But the Irish would be conceding a second-half punishment superbly preserved by Darren 24, Seamus Coleman, who was sent .
After rain had jeopardized Tuesdays game, Switzerlands first-half tempo yielded Benfica striker Seferovic goal and Fernandes hammered at the next in the closing seconds despite Shane Duffys attempts.
With the Republic shifting into a more familiar 4-4-2 in their early 3-5-2 formation, they created second-half pressure but the Swiss company that was held to place themselves back after their defeat in Copenhagen on Saturday.
The Republic still best Group D goal difference from Denmark with Switzerland a point behind but both Danes and Swiss have games in hand, which come against Georgia and out-of-contention sides Gibraltar respectively 15 November.
Slips by the Swiss against Georgia and in their final game in Gibraltar – or Denmark dropping to Gibraltar – only a Republic win against the Danes in their game will be enough to secure eligibility for McCarthys side.
If the Swiss only pick up four points in their last two matches, the Irish would have to win by 2 objectives.
They may still have a places fallback choice if this route fails.
McCarthy passed Brighton youngster Aaron Connolly a first start after his encouraging first-cap cameo in Saturday lure in Georgia but instead it was Borussia Monchengladbachs Breel Embolo who was the attacker in the first half that was pivotal.
With Embolo finding space all too readily, he assisted the carve through the legs of Shane Duffy out a string of first-half chances and Seferovics finish from beyond the box undid the clear method of holding out and irritating the home of that the Republic.
After the Swiss had commanded the first halfof the Republic rallied but beyond using a Glenn Whelan shot blocked, had little to display in the method of opportunities that are clearcut.
Colemans dismissal came after he had been adjudged to have managed an Embolo shot in the 76th minute, which followed his card with the Granit Xhaka of Arsenal.
Randolph saved substitute Ricardo Rodriguezs spot-kick while Fabian Schar also led from the Republic woodwork from the second half.
The screen in Saturdays 0-0 draw in Georgia of the Republic came in for criticism and McCarthy chosen for the formation that was altered as well as three modifications.
Brighton youngster Connolly partnered James Collins in attack as Callum Robinson dropped out, with Preston midfielder Alan Browne carrying over from Conor Hourihane.
As expected, Sheffield Uniteds Enda Stevens returned in place of Matt Doherty but was part of a three-man defence alongside Shane Duffy and John Egan.
Regardless of Saturdays 1-0 defeat by Denmark, Swiss boss Vladimir Petkovic chosen for an unchanged and his faith was rewarded as the home side quickly took control.
The signs were ominous for the visitors as Xhaka tested Randolph at the seventh minute before Swiss player of this year Seferovic blasted reduced through Duffys legs into the internet from just outside the box following Jeff Hendrick header.
In the end, a Glenn Whelan corner was led by Duffy straight before the break but it was a Republic target effort that was rare.
McCarthy introduced Callum ODowda for striker Collins in half-time of after abandoning his three at the formation midway through the half plus it helped the visitors create some strain in the third quarter.
Nevertheless, with Randolph needing to tip more than a Seferovic header, the Swiss continued to carve out the better chances and then visiting Schars header come back off a post.
Connolly was substituted by Scott Hogan on 70 minutes shortly before Colemans dismissal when conceding the penalty, as he picked up a second yellow card.
The heroic Randolph extended to keep out Rodriguezs spot-kick but could do nothing like Fernandes blasted in despite the attempts of Duffy from close range in the final moment of injury-time.

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