Unless Health Minister Micheál Martin intervenes as he has promised, the outlook for him is bleak.
That's the stark reality of the 29-year-old Killorglin man's life and death situation.
It is disgraceful that after waiting three-and-a-half years for a lung transplant, it is apparently being delayed as a result of squabbling between two British hospitals.
In the latest twist of this shocking saga, the Freeman hospital in Newcastle, which gets first-call on donated Irish lungs under a deal signed with the Dublin government, has taken him off the waiting list.
Faced with this terrifying scenario, it is not surprising the cystic fibrosis victim accuses the hospital of playing God with peoples' lives.
So critical is his predicament that firms in the Co Kerry town will shut down for an hour today in protest over the transplant delay.
Hopefully, this will galvanise Mr Martin into more effective action than we have seen from him to date.
It is perplexing that whereas the hospital in Manchester has offered to carry out the transplant operation, using a lung donated from Ireland, for whatever reason its gesture has been blocked by Newcastle's refusal to release a lung.
Given this open clash of interests between British hospitals, it is unacceptable for Mr Martin to adopt a neutral posture, as he did in the Dáil, claiming any decision on a transplant must be a "clinical judgment".
This scenario brings to mind the time-worn adage 'where doctors differ, patients die' with ominous implications in Mr Burke's case.
His plight is harrowing in the extreme. He is literally fighting for his life, which now hangs by a slender thread.
That he has been removed from the list for a transplant operation he desperately needs, is scandalous and totally unacceptable.
Considering the contractual arrangement between the Irish Government and the Newcastle transplant unit, giving it first access to lungs from Irish donors, its decision to hold back the desperately needed lung effectively stymies the Manchester offer to perform the lifesaving operation.
In reality, Billy's life depends on the outcome of next week's review by Department of Health officials, British representatives and specialists from Beaumont and the Mater Hospital where a newly opened lung transplant centre, the only one in Ireland, is not yet in use.
Though Newcastle conducted 47 lung transplants on Irish patients since 1999, it is time for a new contract favouring the Mater.
Against this depressing backdrop, it hard to accept the assurance that everything possible was being done to provide Billy with a lung transplant.
Given the conflicting positions of the British hospitals at the centre of this controversy, a situation first highlighted in this newspaper, he derived cold comfort when Mr Martin, stating the obvious, insisted patient selection must continue to be a matter of clinical judgment.
As Billy put it yesterday, there is an urgent need for Mr Martin to take hands-on responsibility by intervening directly in this debacle.
He should get off the fence and take immediate and decisive action. Otherwise, the outlook for Billy Burke is bleak indeed.